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HomeMy WebLinkAbout11-02-12Reset ~~f2N0~-2 PM 158 PETITION FOR GRANT OF LETTERS ;REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA riPN~~~'~ LG1iT Petition~(ge~r Ito 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: Edwin S. Ernev File No• _~ ~ - (,~ - 1 ~~ ~ I a/k/a: • (Assigned by Register) a/k/a: a/k/a: Social Security No: Date of Death: 10/29/2012 Age at death• 86 Decedent was domiciled at death in Cumberland County, pennsylvania (State) with his/her last principal residence at 336. Messiah Circle. Mechanicsburg Upper Allen Township Cumberland County Street address, Post Office and Zip Code City, Township or Borough Couuty Decedent died at Messiah Villaee Mechanicsbure Cumberland PA Street address, Post Office and Zip Code City, Township or Borough County State Estimate of value of decedent's property at death: r~ p If domiciled in Pennsylvania ............................All personal property $ s p ~ OOd . OJ If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................ Personal property in County $ Value of reel estate in Pennsylvania ......................................................... $ TOTAL ESTIMATED VALUE.... $ 0.00 Real estate in Pennsylvania situated at: (Attach additional sheets, if necessary.) Street address, Post Office sod 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 May 22, 2006 and Codicil(s) thereto dated State retevant circumstances (eg. 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. O NO EXCEPTIONS ®EXCEPTIONS ® B. Petition for Grant of Letters of Administration (If applicable) at.a., d.b.n., d.b.n.c.t.a., pendente life, durante absentia, durante minoritate if Administration, Goa. or db.n.c.ta., 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(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): ..a...o xetanonsut Address Joan L. Erney Daughter 55 Park Avenue, New Cumberland, PA 17070 Form RW-Ol rev. /0/!1/20/! Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Name '~ ~ a Official Use Only C p L'i~i ~d'tJ 'G ~!'1 ~' 58 n"~f ~`~~L`~ a `o~+~ICfST C]A Printed A ess ' Joan L. Ernev 1505 Park Avenue_ New C.umherlanrl pA 1 ~mn ~ 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 Decedent, the Petition •Il well and truly administer the estate according to law. Sworn to or affirmed and subscribed before ~ (~ Date j/- ~ ./,~ me o2- day of Date By Date For the Register Date BOND Required: Q YES ~ NO FEES: Letters ...................... $ 02 (5 )Short Certificate(s)..... . ( )Renunciation(s)...... .. . ( )Codicil(s) .......... .. . ( )Affidavit(s).......... . . Bond ...................... .. Commission ................ . . Other ... • , . . • Automation Fee ............. .. ~• (fO JCS Fee ................... .. TOTAL ................... .. $ 1 To the Register of Wills: Please enter my appearance by my signature below: Attorney Signature: Printed Name: David H. Radcliff /~ Supreme Court ID Number: 25483 Firm Name: Cipriani & Werner, PC Address: 1011 Mumma Ro rl, S»ite_ 201 i.emny~e, PA 1704 Phone: (717)975-9600 Fax: (7171975-3846 Email: dradcliff~jr.-wlaw enm Form RW-01 rev. 10//1/2011 Page 2 Of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } SS: COUNTY OF t _ P„n~ioner(s) Panted Name The Petitioner(s) above of Petitioner(s) and that, a Sworn to or affirmed me this day of By: For the Register Official [,'sc Onl~ ~'~12 X04' -2 PM 1 ~ 58 v,v ~Ul,'~'~r Peu;ioneris) Pruned Address swear(s) or affirm(s) the statements in the foregoing Petition are true and correct to the best of the knowledge and belief zonal Representative(s) of the Decedent, the Petitioner(s) will well and tmly administer the estate according to law. bscribed before Date Date Date Date BOND Required: Q yES ~ NO FEES: Letters ...................... $ ( )Short Certificate(s)...... ~- ( )Renunciation(s)......... ~- ( )Codicil(s) ............. -~- ( )Affidavit(s)............ ---'-' -----_ ond......... ................ Commission .................. --'--- Other ........ ---__ ........ Automation Fee. ~- ... .............. JCS Fee . .................... ---- TOTAL ..................... $ -~ Estate of To ttte Register of Wills: Please enter my appearance by my signature below: Attorney Signature: Printed e• Supreme Cou ID Number: Firm Name: Address: Phone: Fax: Email: DECREE OF THE REGISTER a/k/a: File No: AND NOW, ~(}~ Q ~~~ ~ ~~' ~~ ~ Z satisfactory proof having been presented before me, IT IS DECREED that Letters ons~ration of the foregoing Petition, are hereby granted t - ~~ YLtQ ~ ~ the instrument(s) dated 202. ~j in a above estate and (if applicable) that described in the Petition be admitt d to probate and filed of record as the last Will (and Codicil(s)) of Decedent. n egister of Wills S~ Form R6R0_7 rev. !0/!!/20/! ~~' i"" \/ e2of2 LOCAf~.~~i~l~~~147~'S CERTIFICATION OF DEATH WARNIN1~~i1~: i~iliEg~'1'~t~~tiuplicate this copy by photostat or photograph. Fee for this certit~cate. 56.00 ___ P 188_01665 Certification (~fumt~er yae/Pri et In rman nt Black Ink ~~ ~V.J ~~1i2 h0Y `2 P~ (~ ~~ ' Iti; i; is rt?~, that tic ir,fitt-nuttior; here gi~'en is c.xrecriy co;jie(!~(r~~tJ~. ~(n i)ri~=,inai Certificate ~~f Death .. ~ (:ut,' file(3 with tJ~l, a~ Lescal Etel~istrar. The original Q~(~~;,}`~ vV~~ST c~rtificatc~ ,ril( h~ I(Iruankxl t(7 ~~the State Vital ~'i~~S~R~~ ~~.. ~ Rcc;jr(1~. <)!~fjl:~r ;,,s ;',,ntar)rnt filing. cr z s zo~z i.(JC.j! R('<_lisnar ',Male l~sued COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS rCDTaL'•/~AT State Flle Number: 1. Decedent's Legal Name (First, Middle, Last, Suffix) 2 Sex 3 S i l S . . oc a ecurity Number 4. Date of Death (Mo/Day/Yr) (Spell Mo) Edwin Scott Erney Male 20'1-16 3729 O t ' - c ober 29, 20 12 Sa. Age-Last Birthday (Yrs) Sb. Under 1 Year Se. Under 1 Da 6. Date of Birth (MO/Day/Vea r) (Spell Month) 7 Birth la ty and State o Igo Country) Months Daya Hp,.ra Minut.s ~tarPr~>~`~ur ~°~ g, 86 October 1 9, ~ 926 7b. Blrthpbce (County) Dau i ri B R id a. es ence (State or Foreign Country) Bb. Residence (Street and Number- Include Apt No.) 8c. Dld Decedent Live In a T hlp7 Pennsylvania 336 Messiah Ci l ~ 11 rc ppar A e Yea,de_edantuyedin en zwp Bd. Residence (County) Cumber 1 and 8e. Residence (21p Code) ~ No, decedent lived within limits of city/born. 9. Ever in US Armed Forces? 10. Marital Status at Time of Death I~ Married D Widowed 11. ti iving yse's Narr3q (f~P 1f~ Qlye name prior to first marriage) Q Ves ~ No Q Unknown Q Divorced D Never Married D Unknow C~aro~ fine M~ 11Er 1Z~F~tt1e ' Name (FJrs~OMiddle, L.yl, Suffix)y 1~ Mqt hp r' Narp nrl~Or t Irst la (First, Middle, Last) C~ ~V@r Sl 'LC.. LL 1':rnE aLLler1 ~o n~e~ 14a. Informant's Name 14b. Relatlonshlp to Decedent 1 is Ilan Address (Street and Numbe City, tare, 2 Code) Joan L Ern ~ g ~~d~r ~' `` _ ey Daughter ar c Avenue,New C um~er~and, . . _ _ _ _ _ _ _ _ _ _ _ 1 a. ace o ea[ ec on ~onel f h O _ _ _ _ _ _ _ I Deat ccurred In a Hospital: ^ Inpatient Ilf Death Occurred Somewhere other Than a Hospital d Hospice Facility L] Decedent' N s ome Q Emergency Room/OUtpatlent Q Desd On Arrival Nuraln HOT!/LOn -Term Care Facility Q Other (Specify) b t _ Z iB . Facility a (If not Instlt~tlon, give street and flu bar) am _ lSC. City or Town, Stale, and Zip Code lSd. Coun of Death m S l 1 16s. Method of Disposition ® Burial Q Cremes on 16b. Date of Dlspositlon 16c. Place of Dls tl n Name of cemetery, crematory, or other place) p Removal l St t rom a e o Opn.tipn Nov_ 3, 20'1 2 Emanuel Cemetery Other (Specfy) 16d. Location of Dlspositlon (City or Town, State, and Zip) 1 nature of Fune Se Ice Licensee or P n in Charg of I rment 176 License Number . Lewisberry, PA '17339 ' FO O I2342-L 17c. Name and Complete Address o1 Funeral Facility ~ 16. ecadeM'a Education -Check the box that best dascAbes the 19. Decedent of Hls w 1 7 7 panic Origin -Check the 20 Dac t' R ~ . e n s ace -Check ONE OR MORE races to indices Te what highest degree or level of school completed at the tlme of death. box that best descNbes whether the tlerodent the d d ece ent considered himself or herself to be. Q Bth grade or less Is Spanish/Hispanic/Latino. Check the "NO" 1® White Korean Q No diploma, 9th - 12th grade box If decedent is not Spa nlsh/Hispanic/Latino. O Black or African American Q High tehool rad t GED a g ua e or completed No, not Spanish/Hlspa nlc/Latino Q American Indian or Alaska Native O O[her ASlan Q Some college credit but no degree , ~ Yes, Mexlca n, Mexican American, Chicano ~ Asian Indian Native Hawaiian Q Q Aasaclate degree (e. g. AA, AS) Q Y P es, uerto Rican Q Chinese Guamanian or Cha mono Q Bachelor's degroe (e.g. BA, AB, BS ~ ) Q Yes Cuban , Q Filipino O Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hispanic/Latino Q Ja anese p Q Other Pacific Islander ~ Doctorate (e.g. PhD, EtlD) or Professional degree S f ( peci y) Q Other (Specify) e. MD DDS DVM LLB JO 21. Decedent's Singla Race Self-Designation -Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occu ation -I di Whi f p n cate type o work te O Japanese Q Samoan Q Black or African American O Korman done during most of working Ilfe. DO NOT VSE RETIRED. Q Other Pacific Islander Q AmerlcanlndlanorAlaskaNetlve Q Vietnamese Q Don't Know/NOtSUre Boolc7ceeper O Asian Indian O Other Asian Q Refused 22b. Kind of Business/Industry Q Chinese ~ Natlva Hawaiian ~ Other (Specify) we t $2' s 30re TaX $1.1reaL1 D Filipino ~ Guamanian or Chamorr0 ITEMS 2ga - MUST B! COMPL[TEO 23a. Date Pronounced Dead (MO Day r) 23 b. Signature of P on Pronouncing Death Only when applicab a 23 License Number BY PERSON WHO PRONOUNCES OR ©C ~ ClRTIFI DEATH ~_ ~ ~ ~~~ ~ C/ ~ ~ r 23d. at g ed (MO/Day/Yr) 24. Times of Dear , V F ~ ~_ I ~ 2 ~~ fT~ 25. Was Medical E finer or Coroner Contacted2 [] Yes No CAUSE OF DEATH i 26. Part 1. Enter the chain of eyenb--diseases, Injuries, or complications--that direct) I Approximate y caused the death. DO NOT enter term lnal events h suc as cardiac arrest, I Interval: respiratory arrest, or ventricular flbrlllatlon without sh ow i ng th e etiology . D O NOT ABBREVIATE. En ta g only One cause on a Ilne Add additional Il if . nes necessary. I Onset to Death - n A ~ e v ~ .~ ._ Z IMMEDIATE CAUSE --------------> a. G~.~'Tlcv IaN ~cyTl!/~^L ~~£~R' I (Final diocese or condition I Due to (or as sequen a of): resulting In death) JJ '' Sequentle lly IISY <ond Rions, Due to (or as a consequence of): I If any, leading to the cause ^~ -~~!.. ~~ I listed on Ilne a. Enter the 'T JGya r(/~lfG f JM4 YP1~ / Q Nrt 1/ ~ ~ < X~^ ~ I UNDERLYING CAUSE Due to (or as a con ~ sequence of): (disease or Injury the[ G 1 initiated the events resulting d. R5 O In death) LAST. Due to (or as a consequence f o) 26. Part 11. Enter other ale ifl f dill t Ib H t d h but not r suiting In the underlying cause given in Part I. 27 e i W ~ . a autopsy pe med7 r Qn Ves No 26. Were autopsy findings ayaliable 29. If Female: to c plate the c of death? OQ Ves a No 30 Dld T b r . o acco Use Contribute to Death? 31. Manner of Death Q Not pregnant within past yea Q ~ Natural Q Homicide O Pregnant at time of death b ~' Q No Unkno wn Not pregnant, but pregnant wlthln 42 days of death D Accide ni ~ ~ Pending Investigation Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In ~ Suicide ~ Could not be determined Jury (MO/Day/VrJ (Spell Month) Q Unknown If pregnant wlthln the past year 33. Time of Injury 34. Place of Injury (a.g. home; cons[ructlon site; farm; school) 35. LOCatiOn of Injury (Street and Number, City, County, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Q Yen O Driver/Operator Q Pedestrian ~NO Q Pasaanger Q Other (Specify) 39 Certlfler -physician, certified nurse practitioner, medical a miner/coroner (Check only one): Q`Cartifying only - To the best of my knowledge, death occurred due to the cause(s) and manner stated . Q Pronouncing 6 C.rtlfying - To the bast of my knowledge, death occurred at the tlme, date, and place, and due to the cause(s) and man Q d ner stated. Me ical Examiner/C oro ner -Ion the baz f exam l^s ination and/or investigation, in my opinion, death occurred at the Hme date and lac d , _ - - , p e, an ~ ~ s due to th M e( )yd man stated. Signature of certifier: MM~/slaf ~ ~/M/L TIH f f ~ ~ ~ ~ e o ce rti ler:_ ! . License Number:~J Vyi g~ 39b Nam Add . e, ress and Zip Gode of Person Completing Cause of Death (Item 26) 39c. Date Signed (MO/Oay/Vr) talrw~sc, S wt9 o NIIP•, vJsN~l. fMe~ttans+caba~l, ~1 ' t ~~ Z 40. Registrars District Number 201 41. Registrars lure ~~y~ ',.` / _ ~ ~ i /// 4 e ~ r ar F~ a r M o O / Z a 9 ~T 43. Amend moots ~ C ~~ Disposition Permit No. L~ / _/ ~ (J~_ H705-143 REV 07/2012 LAST WILL AND TESTAMENT ..~, C t-} r~a OF ~ -~ r~ =Q rn ~ :_- -c ~ : ; ~ EDWIN S. ERNEY ~~ <<.: _' N !7~.~ ~ =' ~ ~ c.n I, EDWIN S. ERNEY, of Harrisburg, Dauphin County, Pennsylvania, do make publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. 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 the Executrix out of the property passing under ITEM III of this Will, as an expense and cost of administration of my estate. The Executrix shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. ITEM II: I direct the Executrix to pay my just debts and the expenses of my last illness and funeral expenses from the property passing under this Will as an expense and cost of administration of my estate. -~ T7 n _ _; tiT' ' j ~~ ~. a s:.:~ ,. _~ '_" C7 rn ~~ n 1 ITEM III: I devise and bequeath all the rest, residue and remainder of my estate as follows: (a) One-half (1/2) to my wife, CAROLINE M. ERNEY. In the event my wife predeceases me, this share shall be paid to the beneficiaries set forth in this paragraph at subsection (b) below; (b) One-half (1/2) to be divided in equal shares as follows: 1) One share to my son, DAVID S. ERNEY. In the event my son predeceases me, this share shall be paid to his issue, per stirpes; 2) One share to my daughter, LESLIE ERNEY PANKEY. In the event my daughter predeceases me, this share shall be paid to her issue, per stirpes; and 3) One share to my daughter, JOAN L. ERNEY. In the event my daughter predeceases me, this share shall be paid to her issue, per stirpes. In the event my daughters or my son should predecease me leaving no surviving issue, his or her share shall be equally paid to the other named beneficiaries in (b) above. ITEM IV: In the settlement of my estate, my Executrix shall possess, among others, the following powers: (a) To retain any investments I may have at my death, as long as the Executrix may deem it advisable to my estate to do so; (b) To sell either at private or public sale and upon such terms and conditions as the Executrix may deem advantageous to the estate, any or all real or personal property or interest therein owned by the estate; (c) To pay all costs, taxes, expenses and charges in connection with the administration of my estate; (d) To compromise controversies; and (e) To do all other acts in the Executrix's judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate. ITEM V: Any person who shall have died at the same time as I shall have, or in a common disaster with me, or under circumstance that the order of deaths cannot be established by proof, or within thirty (30) days of my death, shall be deemed to have predeceased me. ITEM VI: I appoint my daughter, JOAN L. ERNEY, to be Executrix of my Estate. In the event my daughter cannot act or refuses to act as Executrix for any reason, I no , 3 ~ constitute and appoint my son, DAVID S. ERNEY, as alternate Executor. Any Executrix/or is specifically relieved from the duty or obligation of filing any bond or other security. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding three (3) pages, at the end of each page of which I have also set my initials for greater security and better identification this 22nd day of May, 2006. S. ERNEY We, the undersigned, hereby certify that the forego~Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testator was of sound mind and memory. Laura J. Hu s Amanda L. Baker Residing at: 123 7~' Street New Cumberland, PA 17070 Residing at: 129 Herman Avenue Lemoyne, PA 17043 4 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF CUMBERLAND I, EDWIN S. ERNEY, Testator, 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 Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. EDWIN S. ERNEY Sworn to and subscribed before i 2nd day of y, . NOTARY PUBLIC My Commission Expires: NOTARIAL SEAL (SEAL) BARBARA SUMPLE-SULLNAN Nofary Public NEWCUMBERLAND BOROUGH CUMBERLAND COUNTY Commission Expires Nov 15, 2007 (SEAL) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF CUMBERLAND We, Amanda L. Baker and Laura J. Hughes-Doyle, 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 Testator, EDWIN S. ERNEY, sign and execute the instrument as his Last Will and Testament; that Testator signed willingly and he executed said Will 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 eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Amanda L. Baker aura J ugh s Sworn to s bscribed bef me~na day NOTARY PUBLIC ~ ~~~ sEAI BARBARA SUMPLE-SULLNAN Notory Fua~ My Commission Expires: NEWCUMBERLAND BOROUGH CUMBERLAND COUMY Commlaslon Ex Nov 1 S, 2007 (SEAL)