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Home My WebLink About10-11-12PETITION 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: Amy G. Yovanovich Decedent's Information Name: Joseph Zedlar File No: 21-12 "°°' ~/~`t,7' a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: 10/02/2012 Age at Death: 94 Decedent was domiciled at death in Cumberland County, pA (State) with his/her last principal residence at 1707 Sherwood Road, New Cumberland 17070 New Cumberland Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at Holy Spirit Hospital East Pennsboro Twp. Cumberland PA Street arJdress, 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 $ 30,000.00 Value of real estate in Pennsylvania ................................................................... $ 85,000.00 TOTAL ESTIMATED VALUE $ 115,000.00 Real estate in Pennsylvania situated at 1707 Sherwood Road, New Cumberland 17070 New Cumberland Cumberland (Attach additional sheets, if necessary.) ® A. Petition 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 Street address, Post Office and Zip Code City, Township or Borough County 07/13/2012 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 g. Petition for 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 ord.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 victim of a killing nor ever adjudicated 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 following spouse (if any) and heirs (attach additional sheets, if necessary): Name Relationship Address ~~ =~ ~ ~ , . ~ ,_ ~ , i.._ ,~ C. ~ . .- Form F?IlV-~2 rev. 10-11-2011 Copyright ;c) 70 i 1 form software cnly Th? !_ac~ner Group, Inc. ~ ~ ` .~. ~`-~: i --~ L n '"'rl `"~ Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } } SS: } Official Use Only Petitioner(s) Printed Name Petitioner(s) Printed Address Amy G. Yovanovich 1406 Chatham Road Camp Hill, PA 17011 :~ C3 r-...~ ~Q Q ,~ :=~'j r~,, CAM ~ ~.. 1__. C~ ~ ~ .. ~" : ; C_' __ Q ~. - --r- , _ _ _.. -. . _ .-..: 4. `'~ !~ 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 Dec ent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or a`.firmed and ubscribed before ~ Date ~, Z- me this. ~ ~~day of ~~ ~ ,~ Date By: ~~ Date - t e Register Date BOND Required? ~ YES ~ NO FEES: ~~~ Letters ..................................... .... $ ( ~ )Short Certificate(s)...... ... ,/ U ( )Renunciation(s) ........... ... ( )Codicil(s) ..................... ... ( )Affidavit(s) ................. ... Bond ...................................... ... Commission ............................. .... Other Automation Fee ........................ .... . L' G~ -~ JCS Fee ................................. .... :7 TOTAL ..................................... ,~~" .s .... $ _ To the Register of Wills: N~ease enter my appearance av my signature peiow: Attorney Signature: ,~--; lr~ ,~ ~p J' ~ ~ I Printed Name: Michael L. Bangs ~~'` ' Supreme Court ID Number: 41263 Firm Name: Bangs Law Office, LLC Address: 429 South 18th Street Camp Hill, PA 17011 Phone: 717/730-7310 Fax: 717/730-7374 E-mail: mikebangs@verizon.net DECREE OF THE REGISTER Date of Death: 10/02/2012 Social Security No: 201-01-4108 Estate of Joseph Zedlar File No: 21-12 -- ~~~ ) a!k/a: AND NOW, j ~ ~ ` , in consideration of the fo~egoinc Petition, satisfactory• proof having been presented before me. IT IS DECREED that Letters Testamentary ~_ are hereby granted to Amy G. Yovanovich in the above estate and (if applicable) that the instrument(s) dated described in the Petition be admitted to prooate and filed of record as the 07/13/2012 and Codicil(s)) c~"'Decedent. Register of Wills Copyright (cj 20 i 1 form software only The Lackner Group, Inc. ~ age of 2 <._. ° a~-n l~a~ t~ ~ 2 OC T I I P 3~ 18 ~~ Type/Print In COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS Permanent CERTIFICATE (7F I7FATH ~' 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo) Joseph Zedlar male Oct_2,2012 Sa. Age-Last Birthday (Yrs) 56. Under 1 Vear Sc. Under 1 Day 6. Date of Birth (MO/D ay/Year) (Spel l Month) 7a. Birthplace (City and S tate or Foreign Country) 9 4 Months Days Hours Minutes Feb 2 7 1 9 1 8 Johns town _ , 7b. Birthplace (County) 8a. Residence (State or Foreign Country) 8b. Residence (Street and Number -Include Apt No.) Sc. Did Decedent Live in a Township? Penna _ 1 7 O 7 Sherwood Rd _ pVes, dace ant lived in twp Sd. Residence (County) . Cumber 1 and ge. Residence (Zip Code) o, decedent lived within limits of NEW Cumber 1 and city/boro. 9. Eve US Armed Forces? 10. Marital Status at Time of Death ~ Married Widowed il. Surviving Spouse's Name (If wife, give name prior to first marriage) es Q No Q Unknown Q Divorced ~ Never Married ~ Unknown 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Nin}to Zedlar Amelia 14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Mailin Address (Street and Number, City, State Zip Code) 0 Amy Yovanovich daughter 1406 Chat~lam Rd_,Camp Hi11,PA 17011 ........................................................... .............._....._................. SSa: Place of Death Check oni one ...... v.......t............................. . s If Death Occurred In a Hospital: Inpatient _ .~+- ~ :If Death Occurred Somewhere Other Than a Hospital: I__I Hospice Facility ~ Decedent's Home ° Emer enc Room Out anent ~ g Y / P ~ Dead on Arrival 0 Nursing Home/Long-Term Care Facility 0 Other (Specify) 15 b. Facility Name (If no[ institution, give street and number; 15c. City or Town, State, and Zip Code 15d. County of Death Holy Spirit Hospital East Pennsboro Twp_,PA17011 Cumberlannd 16a. Method of Disposition urial Q Cremation 166. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) m Q Removal from state 0 Donation OC t _ 6 2 O 1 2 Ro11 ing Green Cemetery s` Q Other (Specify) , ~ 16d. Location of Disposition (City or Town, State, and Zip) Cam Hi 11 PA 1 701 1 ignature of un rvice Licensee -Person in Charge of Interment ~ ~ ~ 176. License Number FD 01 31 63 p , ,~~t ~ 7 - E 17c. Name and G mplete Address of Fun ral a lit Mussedman FH&CSg,3~~ Hummel Ave_ ,Lemoyne,PA 1 7043 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 f= highest degree or level of school completed at the time of death. box that best describes whether the decedent the d nt considered himself or herself to be. ~ 8th grade or less is Spanish/Hispanic/Latino. Check the "No" hite ~ Korean ~ No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. ~ Black or African American Q Vietnamese 0 H school graduate or GED completed ~ No, not Spanish/Hispanic/Latino ~ American Indian or Alaska Native ~ Other Asian Some college credit, but no degree ~ Ves, Mexican, Mexican American, Chicano ~ Asian Indian ~ Native Hawaiian ~ Associate degree (e.g. AA, AS) ~ Yes, Puerto Rican ~ Chinese 0 Guamanian or Chamorro Q Bachelor's degree (e.g. BA, AB, BS) Q Ves, Cuban ~ Filipino Q Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) ~ Yes, other Spanish/Hispanic/Latino 0 Japanese ~ Other Pacific Islander ~ Doctorate (e.g. PhD, EdD) or Professional degree (Specify) ~ Other (Specify) e. MD, DDS DVM, LLB, JD 21. Dace 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 hite 0 Japanese 0 Samoan done during most of working life. DO NOT USE RETIRED. ~ Black or African American 0 Korean Q Other Pacific Islander S a 1 e S ~ American Indian or Alaska Native 0 Vietnamese ~ Don't Know/Not Sure ~ Asian Indian 0 Other Asian ~ Refused 22b. Kind of Business/Industry ~ Chinese Q Native Hawaiian Q Other (Specify) life insurance ~ Filipino ~ Guamanian or Chamorro ITEMS 23a - 23d MUST BE COMPLETED 23a. Date Pronounced Dead (Mo/Day/Yr) 23b. Signature of Person Pronouncing Death (Only when applicable) 23c. License Number BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH A i ~ ®~to UPS- ~ ~ d{ ~ ~~ ~~~I ,~.,. .,-, - ^^" "`~ ~~~ ~~ 23d Date Signed (MO/Day/Vr) 24. Time of Death (~J~ f~ t/ L-~t7bG'(' ~ ~ ~ { ~- ~ j ' CO ~m 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: respiratory arrest, or ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary Onset to Death IMMEDIATE CAUSE > a. MUL-TI t`~12G1A/~1 FA{LU ~~ (Final disease or condition Due to (or as a consequence of): resulting in death) 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 - initiated the events resulting d. z V in death) LAST. Due to (or as a consequence of): 26. Part I1. Enter other significant conditions contributin¢ to death but not resulting in the underlying cause given in Part I 27. Was an autopsy performed? v ~ sTtV~ l-{~A2T FAiLUIZ~ G S / L{G GoNC- £ - O vas No ~ 7 . GN~oNI S To 28. Were autopsy findings available to complete the cause of death? O Ves ~ No - 29. If Female: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death E ° ~ Not pregnant within past year ~ Yes ~ Probably ® Natural ~ Homicide u °J ~ Pregnant at time of death ~ No [g Unknown ~ Accident ~ Pending Investigation ~ Not pregnant, but pregnant within 42 days of death 0 Suicide 0 Could not be determined ~°- ~ 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 Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Q Ves ~ Driver/Operator 0 Pedestrian Q No ~ Passenger ~ 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 ~ 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 ~ Medical Examiner/Coroner - 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) a nd ma nner stated ~I ~1 ~ 1 Signature of certifier: ~-~ Title of certifier: HC~JP(~TA LI ST License Number: M O 44o g-~ ~ 39b. Name, Address and Zip Code of Person Completing Cause of Death (Item 26) f '-7 Q t ~ 39c. Date Signed ( o/Day/Yr) GF-FRNDRAS£_KhIA(L 'D(r.~F~SRRA{~~~ S03 lJc~s^7~h ~J-57`~S'7`-rpe ~°>a-r') ~-~,1 ~ to ~ l~ 40. Registrar's District Number i- a ~~ 41. Registrar's Sign a 42. Registrar File ate (MO/Day/Vr) d ~ ~~ ~~i ~-o~.z 43. Amendments v 0 V D O 2 ~. ~~~ ,fA ~~~ H105-143 Dlsno5ltiOn Permit No. (/ RF\/ n7/7nt'1 n '~~ _~~ c~ ----" ~ -~ ` ~... ~ ~ _.... _. r , ~ ,__;~ ` ~, _ ~ -~ ~"~ C~ i~~ZA~E~~ ~'' °'t'l I, JOSEPH ZEDLAR, 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 all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, and any and all taxes and assessments imposed by any governmental body as a result of my death, whether on property passing under this will or otherwise, shall be paid from my residuary estate as soon as practicable after my death as a part of the expense of the administration of my estate. ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all other articles of household and personal use, equipment and ornament, together with all insurance thereon and relating thereto, in equal shares to those of my issue per stirpes who survive my death by thirty (30) days. ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my possessions and estate of every nature and wherever situate in equal shares to those of my issue, per stirpes, as survive my death by thirty (30) days. ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or attachment. ITEM V. I appoint my daughter AMY G. YOVANOVICH executrix of this my last will. Should my daughter predecease me or otherwise fail to qualify or cease to serve as executrix of this my last will, I appoint my daughter JAN MARIE LEIB executrix of this my last will. ITEM VI. In addition to the other powers and authorities granted to my personal representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all property: to compromise any claim or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as my personal representatives may determine and at valuations finally to be fixed by them; to invest in all forms of property, including any stock or other securities in any corporate fiduciary or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my personal representatives deem proper, without regard to any principle of risk or diversification; to retain any or all assets of my estate, real or personal, without regard to any principle of risk or diversification; to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property and to give options for sales, exchanges, or leases, for such prices and upon such terms or conditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem proper in their sole discretion. ITEM VII. I direct that my personal representatives and fiduciaries shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ~ day of ~~,~..( , 2012. M JOSEPH ZEDLA 2 The preceding instrument, consisting of this and TWO other typewritten pages, each identified by the signature of the testator was on the date thereof signed, published, and declared by JOSEPH ZEDLAR, the testator therein named, 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. ~~ r. '~ ~ ~~ t ,' ~ s ,j ~ ~y. ~ ~ r'~ J'J "'~"ter ~~ / , t~~~ -~ _ _T,; a,~ 3 COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) The undersigned, being the testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~~ y--~ ~~ JOSEPH ZEDLAR r' ' _. Sworn or affirmed to and acknowledged before e by the te~tator~named above ~; this ~ ~ day of'°-E ~ A , 2012. f~oi~r~o~+~~EAI.?H OF PLNNSYI'VAN1A ,~! ~, ; P ..~_~.: ,.--- N C TA :< i f,?. SEAL ~~ ~ ~ `' r ~""""~ Wendy K. Straub, Notary Public ~~~` ~ ~. ~ Lower A!!en Township, Cumberland County 'Notary Public My Commission Expires May i 0, 2015 COMMONWEALTH OF PENNSYLVANIA ) ( SS: COUNTY OF CUMBERLAND ) ~, WE, ~ ~~~t y "~ `~ a ~ ' ` and ~ . ~ ~~ ~ } ~, ~~ ~ ~ ~ ~-- ~ t 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 he signed it willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testator signed the will as witnesses; 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. ~. ~,_ . _ ~ y~'~,~` ~y \"y t`~:l,Y'` `,...tip ~ r x---.__,~.; `.. ' ~L..r~ ' rs I! t,,' Sworn ~r affirmed to-~nd acknowledged before i e thi ~ ~`, day of ~~ ~ '- `~ ,2012. No~arv Public COMI~U~~MJEALTH OF PENNSYLVANIA NUTARIAL SEAL VJondy K. Straub, Notary Public Lower Alien Township, Cumberland County My Commission Expires May 10, 2015 4