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HomeMy WebLinkAbout10-19-12PETITION 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: Lynn H. Mannion a/k/a: -- a/k/a: a/k/a: Date of Death: 10/5/2012 File No: ~ ~ ' e ~~ ~ ~ -''~ (~' _ (Assigned by Register) Social Security No: 68 Decedent was domiciled at death in Cumberland _ County, Penn~vania (State) with his/her last principal residence at 125 S. 27th Street, Camp Hill 17011. Cam~ill - Cumberland -_ _ _ Street address, Post Office and Zip Code City, Township or Borough County Decedent died at Holy Spirit Hospital _ East Pennsboro __ -__-____Cumberland___ PA_- Street address, Post Office and Zip Code City, Township or Borough County Statc 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 ojreal estate in Pennsylvania .............................................................. $ ~~ ~7 ~~,'~s ~.7 Q TOTAL ESTIMATED VALUE.... $ _3.~ ~!~Q_.-~~_~1 Real estate in Pennsylvania situated at: 125 S. 27th St., Camp Hill 17011 Camp Hill Cumberland-_-___ /ANach nclcliliunal ,ehe~~~c, 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) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated .712.7/2007 and Codicil(s) thereto dated _____________ _- - - State relevant circumstances (e.g. renunciation, death oj~recutor, etc.) Except as follows: after the execution of the instruments j 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. ® NU EXCEPTIONS ^ EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (lfapplicable) _ ___ c. t. a., d. b. n., d. b. n. c. t. a. pendente lite, durante absPS7tia. durante mrnorrtuJe If Administration, c.t.a. or cl.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 a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. § 3323(gj 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 necessury): ``~--'- ~ --------- ---Name I ~ _ ___ r - - ---- ---- Relationship ~-- i _._ ---~ - ~ --~.~--- -- =,T., -~-,-~ ~ Address~ ~ ~ ~ ~'~ - " - ~._ rn ~ ~_ _ - --- --~ ~ _ _ _r - 7 v- c1~ _ _ ©~ _.. - ~ t`~ ~ ~ _ - _ _ _ __ .-. --~~---i-- -- --L-!~- ~ -,.,i ~.~,r~~, ~zw-uz rev. io ~t ~o~~ Page 1 of 2 Oath of Personal Representative offe~a~ use on~y ~ i COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Petitioner(s) Printed Name _ Petitioner(s) Printed Address 125 S. 27th Street Laura J. Heiserman Cam Hill PA 17011 220 Louis Lane _ Beth L. Heiserman Enola PA 17025 ---- -- -_ 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 Deceder~#, the Petiti ner(s) will well and truly administer the estate according to law. Sworn to per affirmed an subscribed before `~~ # ~ ~ ~ -- ,~ L. _~ ('`{ i ! ~ ~, ..~ 1 ti.,~( ~ -:~. ;_,,-~ .. .~ ... Date ~~ ~ -- me t is day of _ ' ~~--: ,~, ~ Date Date _ F'or the Register Date c - - ------------ -- --- BOND Required: ^ YES ®NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters ....................... $ ~ Attorney Signature: I ( ~-~; )Short Certificates(s) ...... ~~~~ •C~~~~ ( )Renunciation(s) .......... -__ ~ ~~ ~j ' )Codicil(s) .............. - ~_~ ~`~..;~~,~ ~~x~x-t~-~~ ~,'~•~~t'~i ( )Affidavit(s) ............ . Printed Name: Theresa L. Shade Wix, Esc Bond ......................... ~ Commission .................... Supreme Court Other __ ......... ID Number: 43089 _ _____ _______ Firm Name: WIX, Wenger & Weidner _______ _ -- --- Address: 4705 Duke _treet ___ !, -- - - - -- - --- - --------- ......... Harrisbu rte- ----- F? _ 1 ?~9 - ----- --- -- ---- - ----- ......... C7 .._ ~~ -- Phone: 717 652-8455 `-~ r ~~ ~~ '~` ------- ......... __ - --- ~, 1 _ Fax: ~717~ 652 629_0 rn ~- ~ _._ ___~.-~ Automation Fee ................. - ,~ ~ ~/ - ---- r r - Email: tlsw2000 aol.com ~-' - ` __ -_-T t, Jes Fee ....................... ~ ~• ~ ~ ---- - - ~ - ~ ~ _ . TOTAL ......................$ ~ ~. -~. C'.~ . ~~, --~ ~; _~., - DECREE OF THE REGISTER D -- ~ c~ `,~ ~ I ""'~ Estate of Lynn H• Mannion File No: ~ ~` /-~~ °__ __-__ _--_- a/k/a: _ _ ---- ~ ~~ ...~ AND NOW, ~ ~ ~ t~ ~ ~~~~ )~.- ~ ~ _ -__ , ~~-~---- , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that tters fiC~~t L~ ~ ~ )~~ r~',~~' l _ .- - .-, , - - -- ------ -- are hereby granted to _ ~. L.~_~.Lts~_~ ~ - ~C Y,~'i.1 t`~ r ~'t ~-. ~ i ~ _I?? -1----~.--- 1~~'t' ~1~r~ _ _ ____- ___ _- _____ in the above estate and (if applicable) that the instrument(s) dated ~~ ~~1-~~-~' ~~ _____ _ _ - - described in the Petition be admitted to probate and filed of record as the last V~'ill (and Codicil(s)) of Decedent. . , _ i, Register of Wills f ~(., ~ ~~t ~ ~~' ~(, ~ ~x. T ll ~1 .~~ lr f ~ ' l~i~rm 2W-02 rev. l0 112011 ~~~ ~~ ;,~ge2o2 ll ~ I~~ 1 , I ,~ t~ ;~~v ~ ., ~ _ _ o,s.R,. is ~" ? a.~, ~,; ~ ,v, `,~ i i tf~~~zac~ i9 ~o~ s~ F.. t.,' .:+ ... 1. ...:~'~ 1~~ Ir;iS Y~(1, ' 11s i;.f; ~~li ~~ ~~ OFirN~,rJ'~ 4~~~~~ ' _ ~ ~ .. "~ 1: i ~i° +1 i~ *1!~ ~~:.(. ~6`9~~1) _ ,. Type/Print In COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH VITAL RECORDS Permanent ['FRTIFIr'JsTF AC i'1CAT4.~ ~_ m oe r: 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Dale of Death (Mo/Day/Yr) (Spell Mo) L nn H • ' Man.na:on Female 176-34-8787 October 5 2012 Sa. Age-Last Birthday (Yrs) Sb. Under 1 Year Sc. Under 1 Da 6. Date of Birth (Mo/Day/Year) (Spell Month) 7a. Birthplace (City and State or Foreign Country) Months Days Hours Minutes Harrisbur Penns lvania 68 November 24 1943 , 7b. Birthplace (county) D 8a. Residence (State or Foreign Country) 8b. Residence (Street and Number -Include Apt No.) Sc. Dld Decedent Live In a TOwnshlp7 Penns lvania 125 S . 2 7 th St . puss decedent Ilved in , t,,,,p, Bd. Residence (County) Cumberland Be. Residence (Zip Code) ®No, decadent lived within limits of Camp Hill city/boro. 9. Ever In US Armed Forees7 10. Marital Status at Time of Death p Married [] Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage) Q Yes [~ No Q Unknown ® Divorced p Never Married p Unknown 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) James L. hendrickson Leona M Buhrman 14a. Informant's Name 14b. Relationship to Decedent 14c. informant's Mailing Address (Sercet and Number, Glty, State, 21p Code) Laura Heiserman Daughter 125 S. 27th ST. Camp Hi11, PA 17011 a ......................................................... ......... ....., a. ace o eat ec on one yay If Death Occurred in a Hospital: ~(~ Inpatient ,If Death Occurred Somewhere Other Than a Hospital: l_-1 •Hospice Facility [`~• Decedent's Home p Emer eney Room/Outpatient Dead on Arrival Nursing Home/Long-Term Care Facility Other (Specify) • 15 b. Facility Name (tf not Institution, give street and number, lSc. City or Town, State, and Zip Code lSd. County of Death ~ Holy Spirit Hospa.tal E:_.Pennsboro Twp. Cumberland ~, 16a. Method of Disposition p Burial ® Cremation 16b. Date of Dlspositlon 16e. Place of Disposition (Name of cemetery, crematory, or other place) p Removal from state p Donation 10~9~201 2 Bitner Crematory , LLC Other (Specify) ? i6d. Location of Dlspositlon (City or Town, State, and Zip) 17a. Signature of Funeral Servic Licensee or Person in Charge of Interment 17 b. License Number Harrisburg, PA ~~"~_ q FD-013592-L 17c. Name and Com leis Address of Funeral Facill Hetrick-B~itner Funeral D m 3125 W l S H e~` ° o e, a nut t• arrisburg, PA 17109 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 Thai best describes whether the decedent the decedent considered himself or herself to be. p 8th grade orless is Spanish/Mispanie/Latino. Check the "No" ® White ~ Korean p No diploma, 9eh - ;2th grade ~ box If decedent is not Spanish/Hispanic/Latino. p Black or African American p Vietnamese p High school graduate or GED completed ~ No, not Spanish/Hispanic/Latino p American Indian or Alaska Native p Other Asian p Some college credit, but no degree p Yes, Mexican, Mexican America n, Chicano p Asian Indian p Native Hawaiian p Associate degree (e.g. AA, AS) p Yes, Puerto Rican p Chinese p Guamanian or Chamorro ' pl[Bachelor s degree (e.g. BA, AB, BS) p Yes, Cuban p Filipino p Samoan ' p Master s degree (e.g. MA, MS, MEng, MEd, MSW, MBA) p Yes, other Spanish/Hispanic/Latino p Japanese p Other Pacific Islander p Doctorate (e.g. PhD, Ed D) or Professional degree (Specify) p Other (Specify) e. MO 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 p Japanese p Samoan done during most of working life. DO NOT USE RETIRED. p Black or African American p Korean p Other Paeifle Islander p American Indian or Alaska Native p Vietnamese Communication Director ~ Don't Know/Not Sure p Asian Indian p Other Asian p Refused 22b. Kind of Business/Industry p Chinese p Native Hawaiian p Other (Specify) Non-Profit p FIIlpino p Guamanian or Chamorro ITEMS 23a - 23 MUST BE COMPLETED 23 Dat Pro ounced Dead Mo Day r) 23b. Signature a Person Pronouncing Death Only when applicable 23c. License Number BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH 2 d. Date S ned (MO/Day/Yr) 24. Time of Death 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 compiicatlons--that directly caused the death. DO NOT enter terminal events such as cardiac arrest Interval: , respiratory arrest, or ventricular fibrillati on withou t s h owing the etiology. DO NOT ABBREVIgTE. Enter only one cause on a line. Add additional Tines if necessary = Onset to Death + ~ ~ ~ r -. IMMEDIATE CAUSE --------~ a. `v ` W 5 \ V ~ ~\ L~ p s (Final tlisease or condition Due to (or as a sequence of): lti I d h resu ng n eat ) ~ ~~\\ V`~ _ b. , / y r ~ ~~i~ i i Sequentially list eondl[ions, Due to (or as a consequence of): if any, loading to the cause e r listed on line a. Enter the c. U UNDERLYING GAUSE Due to (o as a consequence f): (disease or Injury that ~ ~ ~ ~ ~ (~ ~ 1 ~1 ~ ^`~ I iti h d J ~ rb ~ /` (t_ ~ ~ \ ~ ircr \ n ate t e events resulting d. 1Y~_ f i in death) LAST. Due to or as a consequence of): 26. Pars 11. Enter other significant conditions contributing to death but not resulting In the underlying cause given in Part 1 27. Was an autopsy p rformed7 ~ p Yes No m 28. Were autopsy findings available ~ to complete the cause of death? p Yes p No 29. If Fe ale: 30. Did Tobacco Use Contribute to Oeath7 31. Manner of Death ~ot pregnant within ast ear s p y p Yes Probably ~Natu ral p Homicide p Pregnant at time of death p No Unknown A id a~( ° p cc ent ~ Pending Investigation p Not pregnant, but pregnan[ within 42 days of death p Suicide p Could not be determined - 1- p Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (Mo/Day/Yr) (Spell Month) p 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 In u j ry (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: p Yes p Driver/Operator p Pedeserlan Q No p Passenger p Other(Spedfy) 39a~~.~!~ertifier (Check only one): ,~L~Certifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated p ronouncing 8. Certifying physicla To the best of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner stated p Medical Examiner/C e O he sis of e a~tio~n, and/or investigation, in my opinion, death occur d at the time, date, and place, and due to th x/a~/m~in e ca u s e(s) and m ann er stated ~ / A w ~ / ' ( ( ( Signature of certifier: ~ ~ s • • -~ Tlile of certifier. ~~~ License Number: `v`r/'-O ~'C ~ \ ~ , 9 .Name, Ad ress and Zip Code of Person omp cling Cause of Des h (1fem 26) ~1 oL~ G m~.s M o ~- l ~~+0 L 1 "rr-Ir~ ~c~i ~. w-, ~'• '` ~ 39c. Date S ned o/Day/Yr) l D 40. Reg =a is District Number 41. R is Signature 42. Reg str r File ate Mo Oay r 43. Amendments ~.` a 4 : ~ c Dlspositlon Permit No_~ O ~~~~~~ - H105-143 REV 07/2011 ~.. ~ .~ _ ~~ LAST WILL AND TESTAMENT o c . ~ -_~=~ =, m --r- << _, OF ~.~._ `r' _' --~ ~, . -- ;~.,_, LYNN H. MANNION ~ ~ © ~~~~. ~' y ~ ~ r..n `~~~ I, Lynn H. Mannion, presently residing in Camp Hill, Cumberland County, ~' Pennsylvania, being of sound and disposing mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils previously made by me. ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether such taxes may be payable by my estate or by any recipient of any property, shall be paid by my Executor out of the property passing under this Will, which is not specifically devised or bequeathed, as an expense and cost of administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax paid by my Executor even though such tax was paid on proceeds of insurance or other property not passing under this Will. If the assets not specifically devised or bequeathed are not adequate for the payment of all such taxes, then the recipients of the property specifically devised and bequeathed shall each pay a pro rata portion of any such tax based upon the valuation of the property received by each such recipient as finally determined for Federal Estate Tax purposes, or if no such determination is made, then for applicable State Inheritance Tax purposes. ITEM II: I hereby exercise all powers of appointment which I may have at the time of my death in favor of my Executor, and all property subject to all such powers of appointment shall be included in my estate. ITEM III. I hereby give, devise and bequeath ten percent (10%) of my estate unto Zion Evangelical Lutheran Church, 2730 Booser Avenue, Pennbrook, Harrisburg, Pennsylvania. ITEM IV: !hereby give, devise and bequeath all the rest, residue and remainder of my estate, whether real, personal or mixed, of whatsoever nature or kind and wherever located, to be divided equally between by daughters, Laura J. Heiserman and Beth L. Heiserman, or their issues per stirpes. In the event that either of my daughters predeceases me and is not survived by children, then the share of the deceased daughter shall pass to the surviving daughter. PAGE 1 OF 4 PAGES ITEM V: In addition to such other powers as my Executor may be granted by law, or under previous portions of this Will, they shall have the following powers: a) To retain investments I may have at my death so long as my Executor may deem it advisable to my estate or trust to do so. b) To vary investments, when deemed desirable by my Executor, then to invest in such bonds, stocks, notes, real estate mortgages, or other securities, or in such other property, real or personal, as they shall deem wise, without being restricted to so-called ~ ~ legal investments". c) In order to effect a division of the principal of my estate or of any trust or for any other purpose, including any final distribution, my Executor is authorized to make said divisions or distributions of the personalty and realty partly or wholly in kind. If such division or distribution is made in kind, said assets are required to be divided or distributed at their respective values on the date or dates of their division or distribution. d) To sell either at public or private sale and upon such terms and conditions as the Executor may deem advantageous to the estate, or any trust, any or all real or personal estate or interest therein owned by the estate or trust severally or in conjunction v/ith other persons or acquired after my death by my Executor, and to consummate said sale or sales by sufficient deeds or other instruments to the purchaser or purchasers, conveying a fee simple title, free and clear of all trusts and without obligation or liability of the purchaser or purchasers to see to the application of the purchase money or to make inquiry into the validity of said sale or sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or other writings which may be necessary or desirable, in carrying out any of the powers conferred upon my Executor in this paragraph or elsewhere in my Will. e) To mortgage real estate, and to make leases of real estate. f) To borrow money from any party, to pay indebtedness of mine or of my estate or of a trust, expenses of administration or inheritance, legacy, estate and other taxes. PAGE 2 OF 4 PAGES g) To pay all costs, taxes, expenses and charges in connection with the administration of my estate or trust. My Executor shall pay the expenses of my last illness and all funeral expenses. h) To vote any shares of stock which form a part of the estate or of any trust, and to otherwise exercise all the powers incident to the ownership of such stock. i) In the discretion of my Executor to unite with other owners of similar property in carrying out any plans for the reorganization of any corporation or company whose securities form a part of the estate or of any trust. ITEM VI: Any person who shall have died at the same time as Testatrix, or in a common disaster with her, or under such circumstances that it is difficult or impossible to determine who died first, or who shall have died less than thirty (30) days after the death of Testatrix, shall be deemed to have predeceased her. ITEM VII: I hereby nominate, constitute and appoint my daughters, Laura J. Heiserman and Beth L. Heiserman, to be Co-Executrixes of this my Last Will and Testament. My Executrixes are specifically relieved from the duty or obligation of the filing of any bond or bonds in this or any other jurisdiction. ITEM VIII: Where appropriate throughout this my Last Will and Testament, all references herein to the singular or the masculine shall include the plural or the feminine, respectively. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, consisting of this, the preceding two (2) pages, and `f the following page this ~ ~~"~ day of `.,~,;~~ , 2007. ~~ 1 t / .~~ '; r ` ~°~ nn H. Mannion PAGE 3 OF 4 PAGES We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year above written, and we certify that at the time of the execution thereof, the said Testatrix of sound and disposing mind and memory. ` (SEAL) Residing at (~ ~ ~ D `- cwt , 1 ~ ~~ ~~n~ , ~.~~~~. (SEAL) Residing ~ ~ ~(~ f ~~ u 1~~ 1'1 ~[ (SEAL) Residing at PAGE 4 OF 4 PAGES ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF DAUPHIN ) I, Lynn H. Mannion, 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; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn t~ or affirmed and acknowledged before me by Lynn H. Mannion, the Testatrix, this ~ ~ -- day of `_ ~ , 2007. s ..~~u-~~ Lynn .Mannion Testatrix :~ Notary P lic COMMON"JVEAL~Ivk~ ~l= PENNSYLVANIA My Commission Expires: Notarial Seat { Gaye L Crist, Notary Public Lower Paxton Twp., Dauphin county AFFIDAVIT My commission Expires Apr. 18, Zoos Member, Pennsy{vani%~ Assorriation of ~lJtaries COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF PHIN ) ~~ ~ ~ l . We ~ ~ ~ '~,,,~,~ - ~~~ and ,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 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 ye of age, of sound mind and under no constraint or undue influence. ~ ,- Sworn to car affirmed and subscribed to before me by ~~~~~~'~ ~~~~, ~,.~ ~ and ,witnesses, this ~~-`~~~ day of `~ , 2007. J r ~. Witness ~, ; ~," ~ \.~ ~ - ~ Witness Witness ,~~!~l Notary Pu is My Commission Expires ~:OMPJIONWEAL~ H O~ l'EI~NS~'LVANIA Notarial Seal ~ Gaye L Crist, Notary Public i Lower Paxton Twp., Dauphin County lNy commission Expires Apr. 18, 2009 Member. PPnr2~u~5~%an's:-< ~c>o~ia~oc~r of rd~taries