HomeMy WebLinkAbout09-27-12PETITION 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 requests the grant of Letters in the appropriate form:
Lloyd E. Penner, Jr.
Decedent's Information ``
Name: Esther F. Penner File No: 21-12 - ~ p ,1
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: 05/06/2012 Age at Death: 91
Decedent was domiciled at death in Cumberland County, pA (State) with his/her last
principal residence at 1000 S. Street, Carlisle 17013 Carlisle Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at Carlisle Regional, 366 Alexander Spring Rd., 17015 Carlisle Cumberland 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 Pennsylvania ...................... All personal property $ 17,000.00
ffnot domiciled in Pennsylvania ................ Personal property in Pennsylvania $
Knot domiciled in Pennsylvania ................ Personal property in County $
Value of real estate in Pennsylvania ................................................................... $
TOTAL ESTIMATED VALUE 3 17,000.00
Real estate in Pennsylvania situated at
(Attach additional sheets, if necessary.)
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) that helshe/they is/are the Executor(s) named in the Last Will of the Decedent, dated
thereto dated
11/04/2009
and Codicil(s)
State relevant circumstances (e.g., renunciation, death o/executor, etc.)
Except as follows: after the execution of the instrument(s) offered for probate, Decedent did not mar 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., pedente lite, du2nte absentia. durante minoritate
If Administration, c.t.a or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.
Except as follows: Decedent was not a party to pending divorce proceedin 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 adgudicated 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 followings a (if any) a eirs (attar~i
additions! sheets, if necessary): to
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Name Relationship Address ~`° ~ r`,- ,
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Form RW-02 rev. 10-11-201 f Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2
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Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland } ~ pr~,':'L^ ; rr '~
f1Cl~'JI ~~, ~~. ~ ~'~~Yt~.~~
Petitioner(s) Printed Name Petitioner(s) Printed Address
Lloyd E. Penner, Jr. 1 Mooreland Ave. i,,t;~;~;r,
Mount Holly Springs, PA 17065 ~~~ vGU~~
.,
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 P~itioner(s) and that, as Personal Representative(s) of the De Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed a sub crib d before O Date 9~~ 7~~~
me th' ' day o , ~` Date
By. Date
or the Register Date
BOND Required? ~ YES ~ NO
FEES:
Letters .......................................... $ 60.00
( 2 )Short Certificate(s)......... 8.00
( )Renunciation(s) ..............
( )Codicil(s) ........................
( )Affidavit(s) ......................
Bond .............................................
Commission ..................................
Other Will 15.00
JCP 23.50
Autmation Fee 5.00
Automation Fee ............................
JCS Fee .......................................
TOTAL ......................................... $ 111.50
To the Register of Wills:
riease enter my aooearance ov my signature oetow:
Name: Jal~(es D. Hughes Esq.
preme Cou~8884
Number:
Firm Name: Salzmann Hughes, P.C.
Address: 354 Alexander Spring Road, Suite 1
Carlisle, PA 17015
Phone: 717-249-6333
Fax: 717-249-7334
E-mail: jhughes~salzmannhughes.com
DECREE OF THE REGISTER
Date of Death:
Social Security No
Estate of Esther F. Penner File No:
a/k/a:
05/06/2012
21-12 ~ l(f(0
AND NOW, ~ ~ ~~ ~~ ,r ~~ c~ 1 ~ , in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Lloyd E. Penner, Jr.
in the above estate and (if applicable) that the instrument(s) dated 11/04/2009
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
f~egister of Wills C
Copyright (c) 2011 form software only The Lackner roup,
LOCAIa~~~~i'S CERTIFICATION OF DEATH
WARNIN~~~~It~~a~~p~guplicate this copy by photostat or photograph.
Fee for this certificate, $6.00
~~' { 2 S~P 21 ~M ~~~ 2. This is to certify that the information here given is
correctly copied from an original Certificate of Death
duly filed with me as Local Registrar. The original
v~Ct`i~. .~~ certificate will be forwarded to the State Vital
L~~T Records Office for permanent filing.
~~.t~
P 18487620
Certification Number
Type/Print In
Per ant
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Lam. Q ~*c~'e,~,~-x~X Ml~l' 1 5/2012
Local Registrar Date Issued
COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
[•R RT~CIf /STF AC P1CATgJ
1. Decedent's egal Name (First, Middle, Last, Suffix)
Ester K
Penner moer:
2
Sex 3.
SO
o
1~ Num
ec
De
(~o[D
yLI'r) (Spell Mo)
4 M
_ F
Z
Q
S
Q
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~
Q Z O Q
~Q zZ
ay
Sa. Age-last Birthday (Yrs) Sb. Vnder 1 Vaar Sc. Under 1 Da
Months Oays Hours Mi 6. Date of Birth (MO/Day/Year) (Spell Month) 7a. BlKhpla (C a d rata or Forol Count
n
t
Ca
r~av ~
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es
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val
a
August ~ , 1 9 2 O 7b. Birthplace (county) um an
Ba. Residence (State or Foreign Country) Bb. Residence (Stree t and Number -Include Apt No.) 8c. Did Decedent Llve in a Township?
-~ Q Q O S Street OYes, decedent lived In
_
Bd. Ref dent! (County)
twp
Cumber 1 and ge. Residence (Zip Code) r 1 i 8 1 e No, decedent lived within limits of Car 1 i s 1 e city/born.
9. Ever In VS Armed Forces? 10. Marital Status at Tlme of Death /~~n-,~' rrled ~ WI o ad 11. Surviving S Name (If wife, give name prior to flnt marriage)
a
u
Q Ves No Q Unknown Q Divorced Q Nev er Marritld
0 Unkno L10yQ
E . Penner Sr
w
12. Father's Name (Firs[, Middle, Last, Suffix) 13. Mother's Name Prior to Flrzt Marriage (First, Middle, Last)
Geer a A1v Kin Clara Edna Cornman
14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Melling Address (Street and Number C~y State 21p C de)
g Llo d P nner r son 1 Mooreland Ave_Mt_HOl1jr Springs, PA
S
J
S If Death Occurred In a Hos Ital~ In •'•• '-' •••••-~- ••••• ••• •• -------
p patient ~ ;If Death Occurred Somewhere Other Than a Hospital: ••• "-
~'( Hospice Fscillty ~ •Decedent's Home
Emergenry Room/Out alien[ Dead on Arrlyal Nursing Home/LOng-Term Care Facility Other (Specify)
G
i SSb. Facility Nam! (If not Insiltution, give strewt and number; 15<. City or Town, rate, and ZI Code 15d. CourLty of Dat{th
~
P
a Carlisle Re ional Carlis
e, P
A 1 70"I 5 Cum er and
.~-, 16a. Method of Disposition ~ Burial ~ Cremation
OR
l f
S S6b. Dale of Disposition 16e. Place of DlsposiTlon (Name of cemetery, crematory, or other place)
emovs
rom
tate QDOna
Other (speglfy) Ho11in er Crematory
5/ l 0/ 2 0 '1 2 g
16d. Location of Disposition (City or Town, State, and Zip) 17a
Slgnaturo of Funersl Service License¢ or Person in Charg¢ of Interment 17b. Ucense Number
Mt_ Holl S rin s PA 1706 QQ
!~ 011589E
7 N d Complete Address of Funeral F ility
o~~~.nger FH&Crema~or
50'I
N
B
lti
'
y _
a
more ave_Mt. Holly Springs, PA
17065
.~ 18. Doudem's Education -Check the box that best describes [he 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to Indicate what
~ highest degree or level of school completed at the time of death. box that best describes whether tM decedent She cadent considered himself or herself to be
th grade or less .
Is Spanish/Hispanic/Latino. Check the ^NO" hire Korean
Q No diploma, 9th - 12th grade bo If decedent is not Spanish/Hispanic/Latino. ~ Black or African American ~ Vietnamese
~ High school Braduste or GED completed o, not Spanish/Hlspanlc/Latino ~ American Indian or Alaska Native Q Other Asian
~ Soma college credit, but no degree ~ Ves, Mexlca n, Mexicsn American, Chicano Q Asian Indian 0 Native Hawaiian
Q Associate degree (e.g. AA, AS)
Q Bachelor's degree (e.g. BA, AB, BS) ~ Yes, Puerto Rican Chinese
Cuban ~ ~ Guamanian or Chamorro
0 Yes
Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA
) ,
~ Filipino Q Samoan
0 Yes, other Spanish/Hispanic/Latino ~ Japanese Q Other P
lfl
I
l
d
~ Doctors[! (e.g. PhD, EdO
or Professional degree ac
c
s
an
er
(Specify) ~ Other (Specfy)
. MD DDS DVM LLB JD
21. O! edlnt'a Single Race Self-DeslgnaHOn -Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work
hit! Q laPanese Q Samoan
~ Bieck or African American ~ Kor done during most of working Ilfe. DO NOT USE RETIRED.
0 Other Paclflc Islander
Q American Indian or Alaska Native ~ Vietnamese O Don't Know/Not Sure Laborer
~ Aalan Indian Q Other Asian Q Refused 22b. Kind of Business/Industry
~ Chinese ~ Native Hawaiian ~ Other (Specify)
l
Q FIIIPIno ~ GuamanianorCham orro Mas
and Carpets
M a - M BE COMPLETED 23a. Date Pronounce Dea Mo Day' r 23 . Signature o Person Pranou neing Death On y w en app Ica le 23c. License Number
By -ERSON WHO PRONOUNCES OR
CERTIFIES DFATH ~~
23 .Date Signed (MO/Day/Yr) 24. Tme of D
e
a
th \ D~ 1 ~.` O ~'`
s
~
s
l 25. Was Medical Examiner or Coroner Contacted? ~ Ves No
CAUSE OF DEATH
Approximate
26. Pert 1. Enter the chain of events--diseases, fnJuries, or complications--that direRly caused the death. DO NOT enter terminal events such as cardi
ac arrest. Interval:
i
respiratory arrest, or ventricular flbrlllatlon without showing the Etiology. DO NOT ABBREVIATE
Enter onl
one c
Il
~-~••J~ .
y
ause on a
ne. Add additional lines If necessary Onset to Death
~ _ 1./V
IMMEDIATE CAUSE ---------------> e. ~T ` )TJV ` ^ ' yy
J l L~ J
(Final disease or condition Oue to (o as a consequ nce of):
resulting In death)
b.
Sequentially list conditions, Due to (or as a sequence of): j
con
If any, leading to the cause
Ilstad on Ilne a. Enter the
UNDERLYING CAUSE Due to (or as a consequence of):
~ (disease or Injury that
~ Initiated the events resulting d.
~ In death) LAST. Due to (or as a consequence of):
26. Part 11. Enter other aJ ifl t diU " Ib ti t d th but no[ resulting in She underlying cause given in Part 1 27. Was an autopsy p med7
g Y!a No
m 28. Were autopsy findings vailablw
• to complete the tau a of death?
29. I1 Female: 0 Yes No
3
d
~ Not pregnant within pass year 0. Di
Tobacco Us Contribute to Death?
33. Manner of Death
Q Probably
~
~' ~ Pregnant at time of death
~ Not pregnant, but pregnant within 42 days of death 0 Natural 0 Homicide
No
~ 0 Unknown ~ Accident ~ Pending Investigation
r- ~ Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In u Q Suicide Q Could not be determined
1 ry (MO/Day/Vr) (SPell Month)
Q Unknown If
pregnant within the pas[ year 33. Time of Injury
34. Place of Injury (¢. g. home; construction site; farm; school) 35. Location of Injury (Sir¢et and Number, City, State, 21p Code)
36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred:
~ Yes 0 Driver/Operator ~ Pedestrian
Q No ~ Passenger ~ Other (Specify)
39a. Certifier (check only one):
Car[tlfying (thyslclan - To the best of my knowledge, death occurred duo to the cause(s) and manner slated
Pro ouncin
A Ce
tH
i
h
g
r
y
ng P
yslclan - To the best o1 my knowl
~ Medical Examiner/C
r
O
h edge, death occurred a[ the time, date, and place, and due to the cause(s) snd manner stated
O
on -
n
a
e b of x minetion, and/or Investigation, in my opinion, d
e
at
h o
c
curred at the time, date, and place, and due to t
h
e cause(s) and manner stated
Slgnaturo of certifier: r
~
~
t
~
G
V
Title of certifier: V--JC y - Llcens! Numberi.iA~~O ~ C~~ (
~
-,
39b. Name, Address and Coda of Person Completing Cause of D
a
th (Item 26)
^
R~ e
`
~
,Y ~ 4. 39c. Drte Signed (MO/Day/Yr)
LO` J _
~~ ~o ~Q
40
Reg strcr s District Number
.
41. Registr ar s tore ~ 42. eglstrar FI a Date Mo Day
43. Amendments a fd
.-r~~\
T
`~~~ ~ ~ ~ ~
pC
J a AA ar-
Disposition Permit No. ~ /_l ~ ~'
H105-143
REV 07/2011
WILL OF
ESTHER K. PENNER
I, Esther K. Penner, of Cumberland County, Carlisle,
Pennsylvania, declare this to be my last Will and hereby revoke all
prior Wills and Codicils.
I direct that all my just debts, funeral expenses,
gravemarker and administrative expenses shall be paid
from my residuary estate as soon as practicable after my
death.
2. I direct that all inheritance, estate, transfer, succession
and death taxes of any kind whatsoever which may be
payable by reason of my death shall be paid out of my
residuary estate.
3. I direct that my entire estate be distributed as fo
C!>~
A. I direct that my entire estate go to my hu d~,
Lloyd E. Penner, Sr. ~
._..,
B. Should my husband predecease me, I direct that
my entire estate go to my children, Dorothy P.
Morrison, Marjorie P. Burkhart and Lloyd E.
Penner, Jr., in equal shares.
C. Should any of my children predecease me their
share shall lapse and be divided into equal shares
between their children.
4. I appoint Lloyd E. Penner, Jr., as Executor of this my last
Will. Should Lloyd E. Penner, Jr., predecease me or
cease to act in such capacity, I appoint Dorothy P.
Morrison and Marjorie P. Burkhart, jointly, as alternates.
5. The Executor of this Will shall have the power to
distribute my estate in kind or in cash, or partly in either.
6. I direct that no Executor acting under this Will shall be
required to enter bond in any jurisdiction.
IN WITNESS WHEREO~j, I_have here to set my hand this
L day of ~ (/ , 2009.
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
~Q~. _ ~ ~
Esther K. Penner
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The preceding instrument consisting of this and one other page
was on the day and date hereof signed, published and declared by
Esther K. Penner as and for her last Will 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 hereto.
LAW OFFICES OF
STEPHEN J. NOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
WITNES
NES
~ ~.
i ~
ACKNOWLEDGMENT
State of Pennsylvania
County of Cumberland
ss
I, Esther K. Penner, the Testatrix, 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 ex ressed.
Esther K. Penner
Sworn to or affirmed a acknowledge b re me by ther K.
Penner, the Testatrix, this day of
2009.
NAT`AR&A~ ~~A~. ___,~... ___. ._w
~ePfeot~.~. ~~~m ~ f~tc~rlk
~ rfe ~~~~~ , ~~ otary ublic/Attorney
~° IDAVIT
State of Pennsylvania
ss
County of Cumberland
We, ~~t~rVlf Sec KS and ~.~SG~. ~ ~~1~~1-, the
LAW OFFICES OF
STEPHEN J. HOGG
19 S. HANOVER STREET
SUITE 101
CARLISLE, PA 17013
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 Testatrix sign and execute the
instrument as her last Will; that the Testatrix signed willingly and
executed it as her free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of
the Testatrix signed the Will as a witness; and that to the best of our
knowledge the Testatrix was at that time 18 or more years of age, of
sound mind and under no constraint r,undue influence.
worn to or affi a and subsc 'bed to before me by witnesses,
this day of i~~ ~20~9.
NOTAAEIAL gi __.._......._._.~
s~nen.-. a~s~. N~~r ~ ai ~ry I
C~rlisls Coro, ~at~€be~r~~nd ~o. P'A
Attorney