The URL can be used to link to this page

Home My WebLink About11-16-12PETITION 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 R Gray a/k/a: a/k/a: a/k/a: Date of Death: 12 File No: 21 - 1 2 - 1 2 d~ (Assigned by Register) Social Security No: Age at death: 85 Decedent was domiciled at death in Cuumberland County, PA (State) with his/her last principal residence at 704 Green Acres Street 17055 Mechanicsburg Cumberland Street address, Post Otfice and Zip Code City, Township or Borough County Decedent died at 111 South Front Street 17101 Harrisburg Dauyhin PA Street address, Post Office and Zip Code City, Tawoship 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 P 1 ...................... g 300,000.00 Value of real estate rn ennsy vanta ........................................ $ TOTAL ESTIMATED VALUE.... $ 300,000.00 Real estate in Pennsylvania situated at: (Attach additional sheets, ifnecessary.) Street address, Post Office and Zip Code City, Township or Borough County ® A. Petition for Probate and Grant of Letters Testamentary Petitionet{s) avet{s) he/she/they is/are the Executor(s) named in the last Will of the Decedent, dated 8/23/89 and Codicil(s) thereto dated Executor MarXL Grav died on 4/12/1990 John R Gray and Michael J Grav Co-Executors under the Will. State relevant circumstances (e.g. renunciation, death ojexecutor, e[c.) 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. 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.xa. or d.b.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): Name Relationship Address M C ~' ~'„ . ,- --¢-, t_; ~ -. OL _ -1 Form RW-02 rev. 10/!1/201! ..~ ro =~~ f ~ `~ Page 1 of 2 r Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Petitioner(s) Printed Name Petitioner(s) Pnnted Address 716 Orchard Court John R. Gra Chambersbur PA 17201 r r t •vi t )tiT ~ ~ ~' ~ •~ ~ ,r, , . . 704 Green Acres Street CI:JMB~~NL~~S~ PA Michael J. Gra •. Mechanicsbur 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 Petitionez(s) and that, as Personal Representative(s) of the Decede~njt~, the Petitioner(s) will well and truly administer the estate according to law. Sworn to r affirmed an subscribed before ~/'/ ~~~y/' Date~~~/~ l ~" met ' - da of 6 ~2 ~~ Date By: ~, Date ~~ ~ / For the Register Date BOND Required: ^ YES ^ NO FEES: Letters ....................... $ ~ ~ ~ v ( ~ )Short Certificates(s) ...... ~ 2 ' ( )Renunciation(s) ......... . ( )Codicil(s) ............. . ( )Affidavit(s) ............ . Bond ......................... Commission ................... . Other ......... I.~.~i l1 ......... ~' ......... •d~ Automation Fee ................ . JCS Fee ....................... c~ 3'~ TOTAL ......................$ ~ ~~ ~J To the Register of Wills: Please enter my appearance by my signature below: Printed Na e: Hubert X Gilroy Supreme ourt ID Num er: 29943 Firm Name: Martson Law Offices Address: 10 East Hi>;h Street Carlisle PA 17013 Phone: (717) 243-3341 Fes: (717) 243-1850 Email: h~ilroyC~martsonlaw.com DECREE OF THE REGISTER Estate of Richard R. Gray a/k/a: AND NOW, ~V~ ~ "~ ~ I~ , ~`_ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to John R Gray and Michael J. Gray in the above estate and (if applicable) that the instrtunent(s) dated August 23 1989 - described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. I~ Register of Wills ~ V ~~ ~ n~~~,-, Form RW-02 rev. 10/11/2011 `x,~~~~~ge 2 of 2 File No: 21 - ~ 2 - ~ •2d Official Use Only tF J .~~~ _; H I05 £~OS REV to/I I I LO , C' d'~AR'S CERTIFICATION OF DEATH ,~~ l,n. WAF~N~t =1~; is~i lepa to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 This is to certify that the information here given is ' correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital QRPH,RN~S COURT Records Office for permanent filing. P 18 8 8 2 6 7 ~uMBERI..A~Ia CO., PA ~ ~~~, , ~,~ 0 2012 Certification Number type/Print In ~ Permanent BI k I k tg3~ a "~~~~ Y a Local Registrar Date Issued COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS R"COT~C~P'JSTC AC glg:ATH __ _. n e 1. Oeeedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. o Death (MO/Day/Vr) (Spell Mo) ~d~ ! /{ / t Rich d Sa. Age-Last Birthday (Yrs) Sb. Under 1 Year Sc. Under 1 Da 6. Date of Birth (MO Day/Vear) (Spell Month) 7a. Birthplace (City and State elfin Country) /~.~ Months Days Hours Minutes Lewistown PA e1F~~ 85 yrs_ October 28 1926 7b. Birthplace (County) Ba. Resldence (State or Foreign Country) 8b. Resldence (Street and Number -Include Apt No.) 8c. Dfd Decedent Live in a Township? 7 0 4 Green Acres St _ Ares, decedent named In ~p~ gd. Resldence (cpunty) Mechanicsbur PA Be. Resldence (Zip Code) -~ 7 No, decedent lived within limits of Mac}] _ boro. c 9. Ever In US Armed Forces? SO. Mar ital Status at Time of Death Q Married Wldowe 11. Surviving Spouse's Name (If wife, give name prior to first marriage) Ves Q No Q Unknown Q Di vorced Q Never Married Q Vnknow 12. father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) 14a. Informant's Name 14b. Relationship Lo Decedent 14c. Informant's Malling Address (Street and Number, City, State, Zip Code) g ......................................................... ........_.............................,............a:...a~e 3....GeY... . e~ pn y one wtY~ ........................................... .....--•--~-•--....................w~...................................... atien[ ~ If Death Occurred Somewhere Other Than a Hospital: r~ Hospice Fa<Ility y Decedent's Home ,n Hos ital: d i f h O $ p p pt ccurre n • I Deat Emerges Room/Outpatient Dead on Arrival ! Q Nursing Home/Lang-Term Cere Faclll Other (Specify) SSb. Facility Name (If not instltutitin, glue street and number; 16c. City or Town, State, and Zip Code 15d. County of Death ~ Harrisbur Hos ital Harrisbur u his 16a. Method of Dlsposltlon Burial Cremation 16b. Dale of Dlsposltlon 16c. Place o1 Disposition (Name of cemetery, crematory, or other place) Q Removal from Stale Q Donation ocher (sp.~i ) 1 O/04 2012 Meehan sbur Cemeter 16d. Location of Dlsposltlon (City or Town, State, and 21p) 17a. Si lure of Funeral 5 rvice Licensee r Per In Cha of Interment a 17b. License Number Mechanicsbur PA 17055 FD-011932-L 37c. Name and Complete Address of Funeral Facility a more V e Mt_ Holl S rin s PA 17 ~' 18. Decedent's E ucat on - c the box Chat 19. e [ of Hispanic Origin -Check the 20. Decedent's Rac -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 himmlf or herself [o be. Q 8th grade or less is Spanish/Hispanic/Latino. Check the "ND" White Q Korean Q No diploma, 9th - 12th grade bo If decedent is not Spanish/Hispanic/Latino. Q Black or African American Q Vietnamese High school graduate qr GED completed No, no[ Spanish/Hlspanlc/Latino Q American Indian or Alaska Native Q Other Asian Q Some college credit, but no degree Q Ves, Mexican, Mexican American, Chicano Q Asian Indian Q Native Hawaiian Q Associate degree (e.g. AA, AS) Q Ves, Puerto Rican Q Chlnase Q Guamanian or Chamorro Q Bachelor's degree (e.g. BA, AB, B6) Q Ves, Cuban Q Flliplno ~ Samoan Q Master's degree (e.g. MA, M5, MEng, MEd, MSW, MBA) Q Ves, other Spanish/Hlspanlc/La[Ino Q Japanese Q Other Pacific Islander Q Doctorate (e.g. PhD, EdO) or Professional degree (Specify) Q Other (Specify) . MD DDS DVM LLB JD 21. De dent'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 la Panese Q Samoan done during most of working Ilfe. DO NOT VSE RETIRED. Q lack or African American Q Korean Q Other Paclflc Islander Q American Indian or Alaska Native QVietnamese QDOn't Know/Not Sure M chanic Q Asian Indian Q Other Asian Q Refused 22b. Kind of Business/Industry Q Chinese Q Native Hawaiian Q Other (Specify) Q Flliplno Q GuamanlanorChamorro Automotive y r 23 . Slgnat Person Pronouncl at (On y w en app ice e 2 MUST BE COMPLETED ate r need Des M N S 2 ~p O ~~ T S ~AT BY PERSON WHO PRONOUNCES OR 3(~J( O/J~ 7 ~~6~f- 24. the of Death 23 S (M /Day/Y}') e 0 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 flbrill n wi[Jtout showing [he et ology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional Tines If necessary Onset to Death IMMEDIATE CAUSE -------- ------> a. s'ML"~~~+ (Final disease or condition Due to (or as a consequence ofJ: resulting in death) b~jl ~ ~~ Zy) },.i) ,~_ ~/L~GI/r-/~tia' i LAC Du to ( r as a consequence of): Sequentially Ilst conditions, If any, leading to the cause c Ajf il./. O M, ' O h A lI _ listed on Ilnc a. Enter the C G[ /C[~(( " ~K F+U..~ ~/!1 UNDERLYING CAUSE Duet as a consequence of): W (disease or Injury that Initiated the events resulting d. ~ In death) LAST. Due to (or as a consequence of): y [~, 26. Part 11. Enter other i I I but not resulting in the underlying cause given In Part I 27. Was an autopsy performed? 25 Q Ves ~ 28. Were autopsy findings available to complete the cause of death? Q Yes No 29. If Female: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death Q Not pregnant within past year Q Ves Q Probably 0/IQatural Q Homicide Q Pregnant at time of death Q No Q Unknown Q Accident Q Pending Investlga[lon ,$' Q No[ pregnant, but pregnant wlthln 42 days of death p Suicide Q Could not be determined Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of Injury (MO/Day/Vr) (Spell Month) Q Unknown If pregnant wlthln the past year 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Lootlun of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: ~ Ves Q Dr1Ver/Operator Q Pedestrian Q No Q Passenger Q Other (Specify) 39a. Certifier (Check only one): Q Certifying physician - To the bas[ of my k I dge, death occurred due to the cause(s) and manner stated Q Pronouncing 8a Certifying physician - To esL my kno a, death occurred at the time, date, nd place, and due fo the cause(s) and manner stated d at the time, date, and place, and due to the cayse(s ) Q Medical Examiner/Coroner - On t inatlo nd tigatlo my opinion, tleaty~ / tetl f~ / d ~ J r~ ~ ~ -~ ~/ t l -. V ~~-/1 //J L Signaturo of certifier: Title of certifier: `T/L /lT License Num~-b~ +./a/_lL rso Completing Caus; f Deyth tam 26) ~ / 39 , Addre and 21p C of 39 e S n (MO/Day r) Jr/~ ~ / / ~ ~ ,, Q J ® 40. Registrars District Num er Regls[ ra is 41. 42. Registrar FI a Date Mo ay r - ~_ i~• sole. 43. Amendments Dlsposltlon Permit No. V 1 -l.~ rh-O I H305-143 REV 07/2011 LAST {BILL ,,AND TESTAMENT OF RICHARD R. GRAY I, RICHARD R. GRAY, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all former Wills ~.., by me at any time heretofore made. ~? ~'°~ 'rT ?' ~~' E•rt C7 y' ~~ Cr ':~ 1. ~ ~ r ..~r:::. I direct the payment of all my just debts and funerahe~t~enses~ `~~ tee as soon after my decease as the same can be conveniently done. ~ 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, of whatsoever nature and whereso- ever the same may be situate, to my wife, MARY L. GRAY, absolutely and unconditionally. 3. In the event that my said wife, MARY L. GRAY, should prede- cease me, or should she die at about the same time as I do, such as in an accident common to both of us, then in such event, I give, devise and bequeath my entire estate, real, personal and mixed, whatsoever and wheresoever situate, to my two sons, to wit, JOHN R. GRAY and -1- MICHAEL J. GRAY, share and share alike, per stirpes. A. I nominate, constitute and appoint THE FIRST BANK AND TRIIST COMQANY OF MECHANICSBURG, PA. to be the Guardian and Trustee of the estate of any minor issue and/or beneficiaries of a de- ceased child of mine who shall share in my estate hereunder, for and during the term of their minority, to wit, until such time as they attain the age of twenty-one (21) years, with the right and authority in said Trustee, at its sole discretion, to apply the principal as well as the income of each such minor's respective estate to insure their comfortable care, support and education, with particular emphasis to the application of said funds to their college education or other technical or profes- sional training after they graduate from High School, without the necessity on its part of first securing a Decree or Order of Court before doing so. 4. LASTLY, I nominate, constitute and appoint my wife, MARY L. GRAY, to be the Executrix of this, my Last Will and Testament, and in the event she should predecease me, or should she be unable or unwill- ing to serve in such capacity for any reason, then I nominate, consti- tute and appoint my two sons, JOHN R. GRAY and MICHAEL J. GRAY, to be Co-Executors of this, my Last Will and Testament, in her place and stead: IN GTiTNESS I~IHERF.OF, I have hereunto set my hand and seal this -2- 3 day of August, A. D. 1989. Richard R. Gray ) Signed, sealed, published and declared by the above-named RICBARD R. GRAY, as and for his Last Will and Testament, in the presence. of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as wit- nesses. -3- COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. I, RICHARD. R. GRAY the testat or 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 volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before me by RICHARD R. GRAY the testator , this 23rd day of August A. D. 1989. COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) tNTAR V : :FAt... MARY 5. R~INSIk. ,:~1sRv t'UiIIG MECWINICSSIIRC, NRD. CitMtERIAND C1. My Ceiwissfen lx~~rts Se't. 21, 19l1 SS. We, the undersigned, J. ROBERT STAUFFER and MARILYN KAY EAIZIN , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testat or , RICHARD R. GRAY , sign and exe- cute the instrument as his Last Will and Testament; that the said testator RICHA~ R, GRAY executed it as his/1,~ 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 the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworn and subscribed to before me this 23rd day of Au ust 1989. NUiA~I~t ~SEAI, MARY S. M6lh3Mr. 1iRTARY rUtLIC MECNANICSWRG NkD. CUMiERLANO CO. ~i ~ s Ceim~issien Ex-ires Sept. 2i. 1911