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HomeMy WebLinkAbout10-5-12PETITION 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: Steven PMorgan -- Decedent's Information ~~©~ Name: Bernice L Morgan File No: 21-12 a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: 09/19/2012 Age at Death: 87 Decedent was domiciled at death in Cumberland County, pA (State) with his/her last principal residence at 801 No. Hanover St., Carlisle 17013 Carlisle Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at Lifecare Hospital of Mechanicsburg, 17055 Mechanicsburg 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 $ If not domiciled in Pennsylvania ................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ................ Personal property in County $ Value of real estate in Pennsylvania ................................................................... $ Real estate in Pennsylvania situated at (Attach additional sheets, if necessary.) 58,000.00 TOTAL ESTIMATED VALUE $ East Pennsboro Street address, Post Office and Zip Code City, Township or Borough ^X A. PP±~+~on for Probate and Grant of Letters Testamentary Petitioner(s) aver(s) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated thereto dated - 23,000.00 81,000.00 Cumberland County 06/15/2009 and Codicil(s) State relevant circumstances (e.g., 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(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. Pet~tinn fer Grant of Letters of Administration (If applicable) c. t. a., d.b.n., d.b.n.c.t.a., pedente lite, durante 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 proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323 (g) and was neither the vlctim of a kllling nor ever ad~udlcated an incapacltated person. NO EXCEPTIONS ~ EXCEPTIONS Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if at~r)~and heirs (attach additional sheets, if necessary): ~ ~~, ~.,-T~ ;-X, ~Y Name Relationship Address rn~i~- ;__ ""~ ` r `~-" .r - Form RW-02 rev. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland } Official Use Only Petitioner(s) Printed Name Petitioner(s) Printed Address Steven P Morgan 203 E. Walnut St. Shiremanstown, PA 17011 ~~ ~ r-a 'T: to ~; ~, ~1 C~"'~ r , ' ~= s .. . m ~I:Z c ......, _ _% ~~ ___ ~. 1 ..,~--, ` ~ ~-r-~ - { - .. ~~ v ,~- The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing P ~ ion are true and correct to the best of the Knowleage ana belief of Petitioner(s) and that, as Personal Representative(s) of the Decedent, Petitlo will w nd r ly administer the estate according la ." Sworn to f~j,~med and b cribed b .ore ~ ~~ ~ ~ ~ ~ Date 1~ me th~s` da of_ ~ ~L, Date By: Date F t Register Date BOND Required? ~ YES ~ NO FEES: Letters .......................................... $ 210.00 ( 2 )Short Certificate(s)......... 8.00 ( )Renunciation(s) .............. ( )Codicil(s) ........................ ( )Affidavit(s) ...................... Bond ............................................. Commission .................................. Other Will 15.00 Automation Fee ............................ 5.00 JCS Fee ....................................... 23.50 TOTAL ......................................... $ 261.50 To the Register of Wills: N~ease enter my appearance py my srgnaiure peivw: Attorney Signature: Gam`; ~ f1 /) % . Printed Name: Linda J. Olsen, Esq. Supreme Court ID Number: 92858 Firm Name: Hazen Elder Law Address: 2000 Linglestown Rd. Suite 202 Harrisburg, PA 17110 Phone: 717-540-4332 Fax: 717-540-4313 E-mail: lolsen@hazenelderlaw.com DECREE OF THE REGISTER Date of Death: 09/19/2012 Social Security No: 164-20-8462 Estate of Bernice L Morgan File No: 21-12 -~ a/k/a: 1 '~ ~ ~ " r AND NOW, , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Steven P Morgan in the above estate and (if applicable) that the instrument(s) dated 06/1 2009 described in the Petition be admitted to probate and filed of record as the last it nd Codicils o^Decedent. Register of Wills "" , ~`~L~. ~,~ Copyright (c) 2011 form software only The Lackner Group, Inc. Pagg~ of 2 ~~ ~ I t V ~ I ' ~..~' ! +L i~ ,: ;,) ( U ~izac~ -s P~ ~~ 47 ...~~ ~ . _ o~~~~~1~ ~~t~ CUM6ERL ~D CU., PA ~:~::~' Type/Print In Permanent B ~~ D Q ~~ ~~ ~~~~~ COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS !`COT~C~!"ATC ('lC IICATL-1 __. __ SEP 2 9 2012 lack In k 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Secu ri[y Number 4. Date of Death (Mo/Oay/Yr) (Spell Mo) t4 `~ ~~ 2 Bernice L _ Morgan Female Sa. Age-Last Birthday (Yrs) Sb. Under 1 Year Sc. Under 1 Day 6. Date of Birth (MO/D ay/Year) (Spell Month) 7a. Birthplace (City and S ll V V tate or Foreign Country) PA 87 Months Days Hours Minutes Apr 11 1 , 1925 1ew, a ey 7b. Birthplace (County) Lly 1 8a. Residence (State or Foreign Country) 8b. Residence (Street and Number -Include Apt No.) Sc. Did Decedent Live in a Township? Penns 1Van1a 80.1 1~lorL11 HanCrver StreE'_t QYes, decedent lived in twP- 8d. Residence (County) (a' IIiltjerlai]d Se. Residence (Zip Code) 17013 No, decedent lived within limits of Car11S12. ,. PA city/boro. 9. Ever in US Armed Forces? 10. Marital Status at Time of Death Q Married Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage) Q Yes :~ No Q Unknown Q Divorced Q Never Married Q Unknown 12. Father's Name (First, Middle, last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Percival Boyer Lillian Herb 14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code) Steven P. N7organ Son 203 East Walnut Street Stlirpmar,~towrt, PA 17011 ~ ~ iSa. Place of Death Check only one) .. .... ..... ......... _,_„ ,,, ,,,, ,,,,,,,,,,, ,,,,, _._,_,................. ..... . ... ..... .... .. ................................... . . ........ . ... ... ... . ili Decedent's Home i F Q H l _~ If Death Occurred in a Hospital: Q Inpatient c ce ac osp : if Death Occurred Somewhere Other Than a Hospita T ~G~ 1 ° Q Emergency Room/Outpatient Q Dead on Arrival _ - Q Nursing Home/long-Term Care Facility ~ Other (Specify) 15 Facility Nam (If ngt ins ituti ,give str t and num er; L~ ~~--t~~ v~ ec~to~n~cs~ut~ 15c. City or Tov.{n, 5 te, and / n1~a Zip Code i5d. County.of^~'ena ~h ~ PW I ASS t~t•Y~•-r~uioct~ ~- 16a. Method of Dispo ition Burial Q Cremation 16b. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) v Q Removal from State Q Donation 12 tember 25 Se Freidens Cemetery p Other (Specify) , p 16d. Location of Disposition (City or Town, State, and Zip) 17a. Signature of Funeral Service Licensee or Person in Charge of Interment 17b. License Number He ins , PA 17938 ,_yg • r~`~ FD 012774-L ~ g 17c. jVame and Complete Address of Funeral Facility Rlctlardson Funeral Home 29 South Enola Drive Enola, PA ]7025 18. Decedent's Education -Check the box that best describes the 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 the decedent the decedent considered himself or herself to be. Q 8th grade or less is Spanish/Hispanic/Latino. Check the "No" White Q Korean Q No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. ~ Black or African American Q Vietnamese High school graduate or GED completed l~i] No, not Spanish/Hispanic/Latino Q American Indian or Alaska Native Q Other Asian Q Some college credit, but no degree Q Yes, Mexican, Mexican American, Chicano Q Asian Indian Q Native Hawaiian Q Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Chinese Q Guamanian or Chamorro Q Bachelor's degree (e.g. BA, AB, BS) Q Ves, Cuban Q Filipino Q Samoan 0 Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispanic/Latino Q Japanese Q Other Pacific Islander Q Doctorate (e.g. PhD, Ed D) or Professional degree (Specify) Q Other (Specify) e. MD, DDS DVM, LLB, JD 21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate type of work White Q Japanese Q Samoan done during most of working life. DO NOT USE RETIRED. Q Black or African American ~ Korean Q Other Pacific Islander Ho1lSedut 125 Q American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure d ustry Q Asian Indian Q Other Asian Q Refused 22b. Kind of Business/In Q Chinese Q Native Hawaiian Q Other (Specify) Q Filipino Q Guamanian or Chamorro ITEMS 23a - 23d MUST BE COMPLETED BY PERSON WHO PRONOUNCES OR 23a. Date rono^un ed Dead (Mo/Day/Yr) / \ ~ / ~ 236. gnatu re of Pers n Pro oun ing B/at~h (Onl whe ap l`ica, ble) ~''~ l , ~.' l / t) I ~ ~/ Z License Nu~~~m~b///e~~~,,,r ~^ ' ~ ^~~{C~ CERTIFIES DEATH ( ~ `~' 1 ~~ 1~.~ lJt///~J~~~_ YYY~~~... 7 , ~J ~J U ` 23d. Da SI ned o Day r) 24. Time f eat . O 25. Was Medical Examiner or Coroner Contacted? Q Yes No CAUSE OF DEATH Approximate 26. Part 1. Enter the chain of events--diseases, injuries, or complications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest. Interval: ne cause on a line. Add additional lines if necessary Onset to Death B /BJREVIATE. Enter only o logy. DO NOT A respiratory arrest, or ventricular fibrillailon without showing the etio o p 7 ' IMMEDIATE CAUSE _______________> a.` O ~ ~ ~S~/y` /~~Q~ ~~^ / /V" ~ (Final disease or condition Due to (or as a consequence of): resulting in death) a /~~ f ~,-- , / b '~ ~ P~ r ~ (~ ( S~~ 5..2 Sequentially list conditions, Due to (or as a consequence of): if any, leading to the cause listed on line a. Enter the c. UNDERLYING CAUSE Due to (or as a consequence of): ~ w (disease or injury that ~ u initiated the events resulting d. Due to (or as a consequence of): in death) LAST. v nditions contrib tin to death but not resulting in the underlying cause given in Part I co 26. Part II. Enter other si nifica nt ^ O /'a^'t it G~ d ~/ ~ ~ S C~ 27. Was an autopsy pearf~ormed? Q Yes L7 No ° ~ ~ ~ .. - c ~ ~7 C/ /~~+'• d n F /^~ [ ~ ~ ~/ 2 Gt 28. Were autopsy findings available to complete the cause of death? Q Yes Q No If Female: Z9 30. Did Tobacco Use Contribute to Death? 31. Manner of Death - o . ~~ Not pregnant within past year Q Yes Q Probably $f Natural Q Homicide v Q Pregnant at time of death Q No ~ Unknown Q Accident Q Pending Investigation °' but pregnant within 42 days of death regnant Not Q Suicide Q Could not be determined I° , ~ p Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (Mo/Day/Yr) (Spell Month) Q Unknown if pregnant within the past year 33. Time of Injury 34. Place of In)ury (e. g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, Slate, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Q Yes Q Driver/Operator Q Pedestrian Q No Q Passenger Q Other (Specify) 39a. Certifier (Check only one): Certifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated Q Pronouncing 8~ Certifying physician - To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated t t d d e manner s a Q Medical Examiner/COr er - On the basis of examination, and or Investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) an ~ ~ S J~ F ~ ~'~ ~~ ~ License Number: f~^ D ~ I ~„~-.ate ~ (G~ ~ Signature of certifier: ~ Title of certifier: 39b. Name, Address and Zip Code of Person Completing Cause of Death (Item 26) n ~ - ~ 39c. L3ate Si ned (Mo/Day/Yr) ~' (z ( f ~ , z r -(3 ~ ~ J ~. m i=_s Ala,,. c .~ , a ~ \ ) ~ e~ ~ o ~ ~- ,.-~ d ,., e 40. Registrar's District Number 41. Registra r~s i nature 42. Registrar Fiie Date (Mo/Day/Yr) 43. Amendments ITEM ~ ~~AD /~~ `~~, __~S-~~ ~~' ~ ~ D SHO JL Disposition Permit No. `~ ~ S~~~ REV 07/2011 ~a '1'1 ~~ C~ ,. riri --~' ~ ----i ~. -` LAST WILL AND TESTAMENT ~ ~~~ ~ ~ '~ T~~l .., OF ~~©~y~ ~ J- .__ '' BERNICE L. MORGAN ~ ~ I, BERNICE L. MORGAN, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may have previously made. Article I 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 my death. Article II 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 any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. e ,-r; ~l P TTT I give, devise and bequeath my tangible personal property in accordance with any memorandum I have handwritten or signed, located with my will or with my valuable papers and found within 30 days of the probate of my will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. To the extent no such memorandum is found, or all of my tangible personal property is not disposed of pursuant thereto, my tangible personal property shall be added to my residuary estate and pass under Article IV hereof. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath IN EQUAL SHARES to my children, STEVEN P. MORGAN, of Shiremanstown, Pennsylvania and CYNTHIA M. STUART, of Albuquerque, New Mexico. In the event STEVEN P. MORGAN predeceases me or fails to survive me by thirty (30) days, then I give, devise and bequeath his share to his issue, per stirpes. In the event CYNTHIA M. STUART predeceases me or fails to survive my by thirty (30) days, then I give, devise and bequeath her share to my son, STEVEN P. MORGAN, per stirpes. Article V I nominate, constitute and appoint my son, STEVEN P. MORGAN, as Executor of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executor, I nominate, constitute and appoint my daughter, CYNTHIA M. STUART, as successor Executrix of my Last Will and Testament. I direct that my Executor or successor Executrix be permitted to serve without bond. 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. 2 Article VI In addition to the powers conferred by law, I authorize my Executor or 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, (f) 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 or successor Executrix; and to pay from my estate reasonable compensation for all their services, (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 3 (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, BERNICE L MORGAN, hereby set my hand to this my Last Will and Testament, on ~ `-' /;..~~~' (~~ ~ , 2009, at Harrisburg, Pennsylvania. BERNICE L MORGAN ~` In our presence, the above-named BERNICE L. MORGAN signed this and declared this to be her Last Will and Testament and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name Address 000 Lin~lestown Rd ,Suite 202, Harrisburg, PA 17110 p. 2000 Linglestown Rd ,Suite 202, Harrisburg„ PA 17110 4 I, BERNICE L. MORGAN, 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 BERNICE L. MORGAN, the Testatrix on ~~~;,~ ~~ ,~<S , 2009. P ~ ~~ Notary Public ~'~ L BERNICE L. MORGAN We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and Subscribed to before me by ~'~ ~ . c: w, and ~~~. P Q.(~~~.mr.~ witnesses, on . `S ;.f~l ~ l,~ , 2009. ~;~ _~ ; Notary Public t_ .. ~ ~ _ ,~ ~ _ ~~ rt ess P Q~~~~ Witn s 5