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Home My WebLink About11-01-12PETITION 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: Richard D. Clepper File No: a ~ - ~ ~ - I ~ ~ D a/k/a: Richard DeWitt Clepper (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: 10/13/2012 Age at death: 84 Decedent was domiciled at death in Cumberland County, pennSy]v is (state) with his/her last principal residence at 108 South ]tidee Road Boiling SprinQS South Middleton Township, Cumberland County Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 361 Alexander Sprine Road Carlisle Middlesex Township Cumberland County Pennsylvania 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 $ 152,000.00 If not domiciled in Pennsylvania ........................Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................ Personal property in County $ Value of real estate in Pennsylvania ......................................................... $ TOTAL ESTIMATED VALUE.... $ 152.000.00 Real estate in Pennsylvania situated at: N/A (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) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated February 10, 2011 and Codicil(s) thereto dated 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(8), and did not have a child born or adopted; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. O NO EXCEPTIONS o EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c.t.a., d.b.n., d.b.n.c.t.a., pendente lite, durante absentia, durante minoritate If Administration, c.t.a. or db.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(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person. O NO EXCEPTIONS o 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): C7 _ :7[7 Name Relationshi Address ~~ ~ ~-?T ~ "~ `-" _. -- ~_ t ~. r - Q ~- ~ O ~ ~.= _N W r._ t D ~ C~ Form RW-02 rev. 10/11/?011 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF LANCASTER J } SS: } Only ~- ~_~C' ~ `_~~- ~E OF r ~~'~ fi!; Y ~'s~l~I LC 012 Nla~~ - I Petitioner(s) Printed Name Petitioner(s) Printed Address Richard L. Cle er 2145 uail Drive Lancaster PA 17601 Q1rtt~H~~1'w J ~,1` ' ,z 0., PA 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 D eat the Petit oner will w 1 and truly administer the estate according to law. Sworn to or affirmed and subscribed before ~ Date i0 ,3/, ~O / 2 me this 31 sT day of Q , ~~ 1 ~ Date gy, nrti ~~ Date For the Register Date Probate Clerk of Lancas ., BOND Required: Q YES Q NO To the Register of Wills: FEES' Please enter my appearance by my signature below: Letters ...................... $ 260.00 ( 8) Short Certificate(s)...... 32.00 ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other Will ........ 15.00 ........ Automation Fee ............... 5.00 JCS Fee ..................... 23.50 TOTAL ..................... $ 335.50 Attorney Signature: Printed Name: Theodore L. Brubaker, Esquire Supreme Court ID Number: 82252 Firm Name: Brubaker Connaughton Goss & Lucarelli LLC Address: 480 New Holland_Avenue Suite 6205 Lancaster, PA 17602 Phone: (717)945-5745 Fax: (717)945-5764 Email: tP..clhnhcgl-law_cnm DECREE OF THE REGISTER Estate of Richard D. Cleaner File No: a ~ - ~ a ` ti ,'~~ a/k/a: Richard DeWitt Clepper AND NOW, U~~,~(1'1 ~'r ( , ~~, inconsideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Richard L. Clepper in the above estate and (if applicable) that the instrument(s) dated February 10, 2011 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. Register of Wills `~ ~ ~~~,' Form RW-02 rev. 10/11/3011 ~, ~ Of 2 LO ;~IT~AR'S CERTIFICATION OF DEATH WA }, ; Is•i l~~f #o duplicate this copy by photostat or photograph. ail;' [_~-' ., 4 ..-L.i~ Fee for this certificate, $6.00 ~^,~~~ ~Qy .. ~ ~~ ~• .~~. ! . ORPHr~I~'~ ~O~Rr P 18 9 7 5 0 7 ~~eERLAND CO., PA Certification Number TVPe/Pflnt In Permanent Black Ink This is to certify that the information here given is correctly copied from an original Certificate of Death duly tiled with me as i,ocal Registrar. The original certificate will be forwarded to the State Vital Rec rds Office for permanent filing. Local Registrar Date Issued COMMONWEALTN OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS CERTIFICATE OF DEATH Slate File NUmt 1. Decedent's Lepl Name (First, Middle, last, Suffix) 2. Sex 3. Soelel Security Number 4. Dat+ of Death (MO/Day/Vr) (Spell Mo) Richard DeWitt Clapper Male 201-18-8255 October 13a 2012 Sa. AB+-L+st Blrehday (Yn) Sb. Under 1 War Sc. Under 1 D+ 6. Oab of Birth (MO/OW/Vpr) (Spell Month) 7a. BiKhplace (City and Stab or Fore{gn Country) 84 Month Days Heurs Mlnut.: South Middleton Totmshi PA April 24a 1928 7b. Birthplace (County) Cumber land Ba. Residence (State or Foralgn Country) Bb. Residence (Street and Numb+r -Include Apt No.) 8c. Dld Decedent Liw In a Tewnship7 Penns ivania ®Y•s, dec•d.nt IlY•d in South Middleton t,,,,p, 108 South Ridge Road Bd. R•sl • u (Ceunt Cumber land de. Residenu (21p Code) 17007 ONO, d+ead+nt Ilvad within limits o/ city/born. 9. Ewr In VS Armed Forus7 10. Marital Statue at Time of D+ath Married WI Owed 11. Surviving Spouse's Name (It wife, give name prior to tint marri+p) Q V•a ®No Q Unknown Q Dlyorud Q Never Married Q Unknow 12. Father's Nam• (Flat, Middle, Last, Suffix) 13. Mother's Name Prior to Flnt Marrlap (Pint, Middle, Last) Charles S. Clepper Hazel Banks r 34a. In o mant's Nam• 14b. Relationship to Decedent 14c. Informant's Mslling Address (Str+et and Number, Clty, State, 21p Gode) Richard L. Clepper Son 2145 Quail Dr sues Laneastera Pennsylvania 17601 ..........."........" ................... ....... .. .................... .. ....... ~:...ac~..°.....~~.-.-... ~e on one"............................. If D++th Ocwrred in • Hes 141: ~~ ~ ~ sswIs~ ...pa"""""""."" ~ ~ """'"""" '"" p IAt In H+nt If Uaa[h Occurred SomewMb Other Than a Hospital: ~ Hosplc~ Fa[ility '~ Oee•dent's Home a Em• •n Roem/Out atleni Oe+d on Arrival Nunin Hem Lo -T+rm Care Facll Other Specify) lSb. F+cllity N+me (H net instltutlon, giw street +nd number; SSc. Glty or town, Sbte, and 21p Cod+ 15d. CounH of Death Carlisle Regional Medical Center Carlisle Penns ivania 17103 Cumberland ~, I6a. Method of Dispoaltlen Burial Cremation 16b. Data of Dlapoaitlon 16c. Pl+ee of OlsposRlon (Name of cemetery, crematory, or other plat+) Q R+meval from State Q Oonatlon Other (Spactly) October 16a 2012 Cremation Society of Pennsylvania 16d. Location W DlspeslHOn (City or Town, Stat+, and Zlp) 17+. Signature of n Service Llcenau or r n In Ch•ye of Interment 17b. Llunse Number Harrisburga Pennsylvania 17109 L FD-013376-L 17c. Name and Compl+b Address of Funeral Fa<Illty Auer Cremation Services of Penner ivania Znc. 4100 Jonestown d Ha ~ 18. Decedent's Eduutlen -Check the box that best describes the 19. Decadent of Nlspanlc ONgin -Check the 20. Decedent's Itaee -Check ONE OR MORE races to Indicate what highest degree or IwN of school eomple[ed at the time of death. box that best describes whether the decadent the decedent considered hlmpN or herself to ba. Q Bth grade or less Is Spanish/Hispanic/Latino. Check the "NO" ®White Q Korean ® No diplom+, 9th - 12th Breda box If decedent is not Spanish/Hispanic/Latino. Q Black or Afrlun Ameriun Q Vletnamesa Q Hlgh school Bnduate or GED complabd ®No, not Spanish/Nlspanlc/latina Q Ameriun Indian or Alaska Native Q Other Allan Q Soma: collep credit, but no tlegraa Q Yes. Mexican, Mexlean AmKlun, Chicano Q Asian Indian Q Native Hawaiian Q Associate degree (e.g. AA, AS) Q Ves, Puerto Rican Q Chinese Q Guamanian or Chamorro Q Bachelor's degree (e.g. BA, A6, BS) Q Y•s, Cuban Q Fillplno Q Samo+n Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hispanic/Latino Q Japanefe Q Other Paelfic Islander Q Ooetonte (a.g. PhD, EdO) or Prolsasion+l d+gree (Sp+clfy) Q Other (Specify) . MD DDS DVM LLB JD 21. Decedent's Sinile Race Self-Oeslgnation -Check ONLY ONE to Indicate what the decedent cenaltleretl hlmsMf or herseN to be. 22a. D•cetlent's Usual Occupation -Indicate type o7 work ® Whlb Q JaP+nese Q Samoan done during most of working Ilia. 00 NOT USE RETIRED. Q Black or African American Q Korean Q Other Pacific Islander Q American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure Signalman Q Asian Indian Q Other Asian Q R•TuaW 22b. Kind of Business/Industry Q Chinese Q Native Nawailan Q Other (Specify) Q Fillplno Q Guamanian or Chamorro Conrail RR B MPL D 23a. Date Pronounu Dn (MO Day r 2 . Signature o anon Pronouncing Death Only when app i<able) 23c. License Num er CBRTIR~ DEWJLTN PRONOUNCES OR ~ 0 ~ 13 1 ~• O ~ ~~ l 23d. Dab SILMd (MO/Day r) 24. Time of Death 25. Wes Medlin Examiner or Coroner Contacted? Q yes No CAUSE OF DEATH Apprexlmata 26. Pen 1. Enbr the [halo of events-dis+as•a, injuries, or complleatlona--that directly caused the death. 00 NOT enter brminal events such as cartliac arrest i Interval: respiratory arrest, or ventricular nbrilletlon witho u t showing Sh e etiology. DO NOT ABBREVIATE . Entsr only one cause on a Ilna. Add additional Tines If necessary Onset to D+ath / ] / t + IMMEDIATE GVUSE -------------> Il CG Pf't -R~ 2. V ~/-~/ ~ 1~ eG~ (Final disbse or condition Due (Or as a wnsaquenCa o•): 3 resulting In death) _ ~ S b ' 2 4 -~- i ti~ O PS / j ~ . ! n EV r t_1 M /~ Sequentially Ilst conditions, Due to (or of a cons•q cote of): j if any. Ipding to tM cause /. ^ S ~ ~ i Ilsbd on Ilne a. Enbr the G~ /_' VNOCRLYINO CAUSE Dw to (or as a consaquenee of): 3 ¢Y (di»ase or Injury that F Inltlated the events resulting d. ~ ~ In desth) LAST. Due to (or as a consegwnce of): 26. PaR 11. Enter other sieninunt eendltiana contributive to death but not resuking In the underlying cause [Ivan in Part I 27. Was an autopsy P rformetli Q't•"'~"'^°-y J`yPt:-7LJtNS~r~N~ vbe-1-~/c~~e S`lse . ,.Fptir l ~ to . ~ ~ v 2s.w. p:ynndlnB:. .an.me to complete eh• cause of dath7 yyy Ves No 29. If Female: 30. Did Tobacco Use Contribute to Deaths 31. Mannar of Death Q Not pregnant within past year Q V•s Q Probably ~ NaturN Q Homicide Q Pregnant at time of death N ~ Q o Unknown Accident Q vending Investigation Q Not prgnant but pregnant within 42 da s of d th , y ea Q Sulclde Q Could nor be determined Q Not re n nt b t 3 d p a , u pr+gnant 4 g ays to 1 year before death 32. Date of Injury (MO/Day/Vr) (Spell Month) Q Unknown If pregnant within the peat year 33. Time of Injury 34. Platt of Injury (e.g. home; eonstructlon site; farm; school) 34. Location of Injury (Sereet and Number, Clty, Sbte, Zip Code) 36. Injury at Work 37. If Transportatbn Injury, Sp+clfY: 3B. Describe How Injury Occurred: Q Vas Q Driver/Operator Q PedesYMan Q No Q passenger Q other (spetlfy) 39a. certreer (check emy en.): Q CertlfYing Phyficl+n - To the best oT my knowledge, death occurred tlus to the cause(s) and manner sbbd ~ $ Pronouncing a Certifying physician - To the best of my knowledge, death occurred at the time, data, and place, and due to the caul+(s) and manner stated s Q Medlin Examin+r/COr - On the b 7 exa laation, and/or Investigation, in my opinion, death occurred at the time, dab, and piece, and due to the eauu(s) and manner stated Signature of certHler: - Title of certlRer: ~~~ LI<ense Number: /~l(L~190~ 39b. Name, Address and Zlp Code of Person Completing Guse e1 Death (Ibm 36) 39c. Date Slg +d (MO Day/Yr) -L N C.'sal~ io JaS zvJz 40. ReB{sitar s District Num 41. egistrar a S gn cure 42. Registrar D+b Mo ay ~-1 /O _ / ~~~CX 43. Amendments ~,p N104-143 Disposition Permit No. V A f ~'~ I~ REV 07/2011 e ~ WILL I, RICHARD D. CLEPPER, of Boiling Springs, Pennsylvania, revoke my prior wills and declare this to be my last Will: GIFTS FIRST: PERSONAL AND HOUSEHOLD EFFECTS: I give all my articles of personal or household use, including automobiles, together with all casualty loss insurance relating thereto, to my children, RICHARD L. CLEPPER and PATRICIA G. RAVER, or the survivor, to be divided among them as they may agree. In the absence of agreement, all such property shall be sold and the proceeds thereof added to my residuary estate. SECOND: RESIDUARY ESTATE: I give the residue of my estate, real and personal, as follows: A. One-half (1/2) to my son, RICHARD L. CLEPPER, or, in the event that he does not survive me, to his then-living issue, per stirpes, or in default of such issue, pursuant to Paragraph B. of this Article SECOND. B. One-half (1/2) to my daughter, PATRICIA G. RAVER, or, in the event that she does not survive me, to her then-living issue, per stirpes, or in default of such issue, pursuant to Paragraph A. of this Article SECOND. ADMINISTRATIVE PROVISIONS ~.~.~ c~ ~ ~ ~"' ;~,,T"i THIRD: SURVIVORSHIP: If a beneficiary fails to survive me by thirt~.~iayshat%.;~ r'1 a ~_ ' ~~ . ~, ~ beneficiary shall be deemed to have not survived me. ~ ~ ~ 7 ~, _ - ~~ ~ ~ ~ -- ~~ _ -- r, <-1 - - {00608250.1 } ~ -}' 'L7 ~ ' ~ ~~ ?> FOURTH: DEATH TAXES: All federal, state and other death taxes payable because of my death on the property forming my gross estate for tax purposes, whether or not it passes under this Will, shall be paid out of the principal of my probate estate so that the burden thereof falls on my residuary estate, and none of these taxes shall be charged against any beneficiary or any outside fund. This provision shall not apply to generation-skipping transfer taxes. FIFTH: TAX OPTIONS: I authorize my executor to exercise any options available in determining and paying death taxes in my estate as my executor deems appropriate, without regard to any effect upon the size of the marital deduction and without requiring adjustments between income and principal. SIXTH: BENEFICIARIES UNDER THE AGE OF TWENTY-FIVE (25~ -CUSTODIAN: I appoint such individual or corporation (including a fiduciary serving hereunder) as is designated in writing by my executor as custodian under the Uniform Transfers to Minors Act ("Act") for (i) any beneficiary who has not attained age twenty-five (25) at the time an interest is distributable outright to him or her under the terms of this Will or (ii) except to the extent a valid appointment of a custodian has otherwise been made, any person who has not attained age twenty-five (25) at the time an interest is distributable outright to him or her as a result of my death, from any other source. The custodian shall hold such property in an account established under the Act and shall from time to time expend for the benefit of the beneficiary such of the income and principal of such account as the custodian shall, in the custodian's discretion, deem appropriate and in accordance with the Act. Upon the beneficiary attaining the age of twenty- five (25) years, the custodian shall pay to the beneficiary all then remaining property in such account; provided, however, that should any person for whom property is held in an account {oo6oszso.i} _ 2 _ under this Article SIXTH die before attaining the age oftwenty-five (25) years, the property then held in such account shall be paid to the estate of such person. SEVENTH: MANAGEMENT PROVISIONS: I confer upon my executor under this Will all powers granted to fiduciaries under the laws of the Commonwealth of Pennsylvania, whether my estate is administered in the Commonwealth of Pennsylvania or elsewhere. In addition to the powers granted by law, I authorize my executor or other legal representatives of my estate serving under this Will to: A. Retain and invest in any form of real or personal property regardless of (i) any limitations imposed by law on investments by executors, (ii) any principle of law concerning delegation of investment responsibility by executors or (iii) any principle of law concerning investment diversification; B. Compromise claims and abandon any property which, in my executor's opinion, is of little or no value; C. Borrow from anyone, even if the lender is a trustee hereunder, and pledge property as security for repayment of the funds borrowed; D. Sell at public or private sale, exchange, lease or lend for any period of time, any real or personal property, and give options for sales or leases; E. Make loans to, and buy property from, my executors or administrators or the trustee of any generation skipping trust of which I am a deemed transferor; F. Join in any merger, reorganization, voting-trust plan or other concerted action of security holders, and delegate discretionary duties with respect thereto; {oo6os2so. i } -3- G. Allocate any property received or charges incurred to principal or income or partly to each, as my executor may think reasonably appropriate; and H. Distribute in cash or in kind or partly in each. These authorities shall extend to all property at any time held by my executor and shall continue in full force until the actual distribution of all such property, except as otherwise specifically stated. All powers, authorities, and discretion granted by this Will shall be in addition to those granted by law and shall be exercisable without court authorization. EIGHTH: PROTECTIVE PROVISION: NO interest in income or principal shall be assignable by, or available to, anyone having a claim against a beneficiary before actual payment to the beneficiary. FIDUCIARIES NINTH: EXECUTORS: I appoint my son, RICHARD L. CLEPPER, executor of this Will, but if he is unable or unwilling to act, I appoint my grandson, TIMOTHY B. CLEPPER, executor of this Will. No executor shall be required to give bond. Executed: February 10, 2011. (SEAL) Richard D. Clepper In our presence the above-named testator signed this and declared it to be his Will, and now at his request, in his presence, and in the presence of each other, we sign as witnesses: Address 221 East Chestnut Street _ Lancaster, PA 17602 -4- Street Lancaster, PA 17602 ~-- ~ . ~, {ooboszso.~} COMMONWEALTH OF PENNSYLVANIA COUNTY OF LANCASTER ss. We, RICHARD D. CLEPPER, THEODORE L. BRUBAKER and BETSY E. BOLACK, the testator and witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his last will and that he had signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator signed the Will as witness and that to the best of their knowledge the testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testator Witte r~ . J ~ ~~~~~ Witness Subscribed, sworn to and acknowledged before me by RICHARD D. CLEPPER, the testator, and subscribed and sworn to before me by THEODORE L. BRUBAKER and BETSY E. BOLACK, witnesses, on February 10, 2011. Notwtlr nreuc pill . ER, tAMCASIER COUMir Commission Expires: ~)/1 / /l3 {oo6oszso. i } -5-