HomeMy WebLinkAbout12-05-12PETITION FOR GRANT OF LETTERS
REGISTER OF WILLS OF (,G(lN hP~ /r?, n~ 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(,) the following and respectfully request(s) the grant of Letters in the appropriate form:
Decedent's Information
Name: l~zrtx~/a ~ f-latz<
a/k/a:
a/k/a:
a/k/a:
Date of Death: ll- 16 - col ~
Decedent was domiciled at death in
principal residence at a 69 _!f/1
File No: (/!~~ ~t~ ~~ ~o I
(Assigned by Register)
Social Security N
Age at death: _ '7(y
County,
(Srrtre) with his/her last
Street address, Post Office end Zip Code City, Town ip or Borough County
Decedent died at O/tr_ VYIQ_S~t/11'C ~n i t ~~j ~a 6tih /ty,J~ Q/} l7l~,J Lq~~ ~ }/r p>q
Street address, Post Omce and Zip Code City, Townahip or Borough County State
Estimate of value of decedent's property at death:
ljdomicded in Pennsylvania .......................... .All personal property $ ~ /~ a /JD U
If not domiciled in Pennsylvania ........................ Personal property in Pennsylvania $
Ifnot domiciled in Penxsylvania ........................ Personal property in County $
Vrtlue ojreal estate in Persnsylvania ............................................ ............. $ - 0
TOTAL ESTIMATED VALUE.... $ ,~ 3 7 U
Real estate in Pennsylvania situated at '? .~p(,l,{{~I Qe~ m([han i[Sly~,s Rf}-17USY S' )Jtr Gri n~ ~'U mt){~Ip~~
(AUnch additiona[sheets, ifnecessary.J Street address, Post O(Bce end Zip Code Clty, Township or Borough County
[tr]~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 Wilt of the Decedent, dated !J lag ~ /a and Codicil(s)
thereto dated
stare relevant circumstances (c.g. renunciafian, death afeeecutar, err.)
Except as follows: after the execution ofthe instrument(s)offeredforprobate Decedentdid not marry, was not divorced, was notaparty to spending
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; slid Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
[~'O 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 litv., durunte absentia, durunte minoritute
If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and com lete ' of heir
Except as follows: Decedent was not a party to a pending divorce proceeding wherein the groundsQar divorce had ~een es~li p~d as defined
in 23 Pa. C.S. § 3323(8) and was neither the victim of a killing nor ever adjudicated an incapacitatet{~CrSa7i. t~ G'1 Q
^NO EXCEPTIONS ^EXCEPTIONS _ t9 ~u _ cm-o c:~
Petitioner(s), after a proper search has/have ascertained that Decedent left no W ilt and was survived by t~1'o~w~gg spo{~p(if an~pttl
additional sheets, ijnecessary): T> ~ ~ p Kp
.~ -sy
Name Relationshi ~ ~ .,~ _...
O C ~7 ~ r+t
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is
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Po„e 2w-nz ray. miurznrr Page 1 of 2
RECn~;^~^ ~,. .,.~ ,,..
RECiS..: , Ui= ,
2Ci7 CSC
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
}
} ss:
COCVTY OP
~LEiiK C~
lPNANS' CC'JF;T
BERLAND CQ., Pti
Petitioner(s) Printed Vane Per„ioneris~~ Footed address
Clndt /fake k5 ycadw~// Cn /Y)PChanits/ati p~ /7oS~
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) ofthe Decedent, the Petition/er(s) will well and tmly administer the estate according to law.
Sworn to or firmed a d subs ribed before ~/~C2~~ Q /VC(,.~C Dale lol'S-/ a
met ' y f (~~ Date
By Date
For egister Dale
130ND Required: Q YE5 I ~{1V0
FEES: T
f-esters ...................... $
(l G )Short Certificate(s)..... .
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
E3ond ........................
(:oinrnission.. ........
Other ~_........
Automation Fee... ~
JCS Fee. ... .
TOTAL ..................... $
Ta the Register aj Wii[s:
Please enter my appearance by my signature below:
Attorney Signature:
Printed Name:
Supreme Court
ID Number:
Firm Name:
Address:
Phone:
Fax:
Email:
DECREE OF THE REGISTER
Estate of (I S~i~~ ~ ~ File No: (,Y ~ - I ~ ' I o~ C~
a/k/a:
AND NOW, _,~ Z~~ ~ ~ ~~ , in con ides ion of the foregoing Petition,
satisfactory proof having been presented before me, IT IS EC ED tha ett ~ ~,l
_ are hereby granted to '
in the above estate and (if applicable) that
the instrument(s) dated ~ _ /.~ ~ ,~
described in the Petition be admitted to probate and filed of p~'orid as the last ill nd Codicil(s o Decedent. /
of Wills
Farm R4V-01 rev miuiaorr ~{ `~ o Pee 2 of 2
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat or photograph.
RECORDED OFFICE OF
Fee ror this certiricar. ~;~.oo REGISTER OF'~'ILLS
(Ll~ OEC 5 R(~ 9 0~
CLERK OF
P 1$ $ $ G 01 ORPHANS' COURT
Certification Number-BER~AND CO., PA
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[OMMOxwF4rxpF VFNXSVLV.1xIP•UFVn1iMFxi pi Nf.LIX•VI,YRECOIrUs
LERTIFILATF AF HEATH
This is w certify that the information here given is
correctly copied from an original Certificate of Death
duly tiled with me a6 Local Registrar. The original
certifica[c will he forwarded to the State Vital
Records Office for permanent filing.
() r
Local Rr„gislrar Date Issued
__ _,.
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LAST WILL AND TESTA.R~A~ `~ (l ~ ~ ~ S E 0 F
OF REGiS?cR 0 ~iiLLS
BARBARAHAKE~,„1? ~~~ 5 Ail 9 05
CLEE2K Cc
I, Barbaza Hake, of Mechanicsburg, Pennsylvania, revoke my fo~r~i~l$'aa6 CCBdicils and
declaze this to be my Last Will and Testament. CUMgERLaND ~~~~ PA
ARTICLE I
IDENTIFICATION OF FAMILY
I am not currently married to anyone.
The names of my children aze Wendy A. Hake and Cindy J Hake. All references in this Will to
"my children" are references to the above-named children.
The failure of this Will to provide for any distribution to my child(ren), Barry R Hake, David A
Hake and Timothy S Hake, is intentional.
ARTICLE II
PAYMENT OF DEBTS AND EXPENSES
I direct that my just debts, funeral expenses and expenses of last illness be first paid from my
estate.
ARTICLE III
DISPOSITION OF PROPERTY
A. Specific Bequests. I direct that the following specific bequests be made from my estate.
1. Jewelry, Clothing & personal effects shall be distributed to Wendy A Hake. If this
beneficiary does not survive me, this bequest shall be distributed to Cindy J Hake. If this
beneficiary does not survive me, this bequest shall be distributed with my residuary estate.
2. Volvo vehicle shall be distributed to Cindy J Hake. If this beneficiazy does not survive me,
this bequest shall be distributed with my residuary estate.
3. My remaining tangible personal property shall be distributed to Wendy A. Hake. If this
beneficiary does not survive me, this bequest shall be distributed with my residuary estate.
B. Residuazy Estate. I direct that my residuary estate be distributed to Wendy A Hake,
Mechanicsburg, Pennsylvania. If such beneficiary does not survive me, my residuary estate shall
be distributed to the following beneficiaries in the percentages as shown:
100% - Cindy J Hake, Mechanicsburg, Pennsylvania. If this person does not survive me, this
shaze shall be distributed proportionately to the other distributee(s) listed under this
provision.
100 -Percent Total
ARTICLE IV
NOMINATION OF EXECUTOR
I nominate Cindy J Hake, of Mechanicsburg, Pennsylvania, as the Executor, without bond or
security.
ARTICLE V
EXECUTOR POWERS
My Executor, in addition to other powers and authority granted by law or necessary or
appropriate for proper administration, shall have the right and power to lease, sell, mortgage, or
otherwise encumber any real or personal property that may be included in my estate, without
order of court and without notice to anyone.
My Executor shall have the right to administer my estate using "informal", "unsupervised", or
"independent" probate or equivalent legislation designed to operate without unnecessary
intervention by the probate court.
ARTICLE VI
MISCELLANEOUS PROVISIONS
A. Pazag_ranh Titles and Gender. The titles given to the paragraphs of this Will aze inserted for
reference purposes only and aze not to be considered as forming a part of this Will in interpreting
its provisions. All words used in this Will in any gender shall extend to and include all genders,
and any singulaz words shall include the plural expression, and vice versa, specifically including
"child" and "children", when the context or facts so require, and any pronouns shall be taken to
refer to the person or persons intended regazdless of gender or number.
B. Liability of Fiduciazv. No fiduciary who is a natural person shall, in the absence of fraudulent
conduct or bad faith, be liable individually to any beneficiary of my estate, and my estate shall
indemnify such natural person from any and all claims or expenses in connection with or azising
out of that fiduciary's good faith actions or nonactions of the fiduciazy, except for such actions or
nonactions which constitute fraudulent conduct or bad faith. No successor trustee shall be
obliged to inquire into or be in any way accountable for the previous administration of the trust
property.
C. Beneficiary Disputes. If any bequest requires that the bequest be distributed between or
among two or more beneficiazies, the specific items of property comprising the respective shares
shall be determined by such beneficiaries if they can agree, and if not, by my Executor.
IN WITNESS WHEREOF, I have subscribed my name below, this ;~~i "'' day of
n(tunir , (ij1
Testator Signature:
Sazbaza Hake
-.
We, the undersigned, hereby certify that the above instrument, which consists of ~ pages,
including the page(s) which contain the witness signatures, was signed in our sight and presence
by Bazbaza Hake (the "Testator"), who declazed this instrument to be his/her Last Will and
Testament and we, at the Testator's request and in the Testator's sight and presence, and in the
sight and presence of each other, do hereby subscribe our names as witnesses on the date shown
above.
Witness
Nan
City
Stag
Witness
Nan
City
Stat
RECOROEO OFFICE OF
REGISTER OF ="ll! LS
2L'12 CEC 5 A(~ 9 05
CLERK OF~TH OF 5LBSCRIBI\G ~~'IT\ESS(ESj
ORPHANS'COURT
CtlM$ERLAND GO., PA REGISTER OF WILLS
COUNTY, PENNSYLVANIA
Estate of ~ C1 tr b~itf ~ ~~ l ~ e , Deceased
N eC(--~ h P~ ~h ycf of , `I0~ f ~1 e ~5 url . (each). a subscribing witness to
(Print NanehJ
the ^ Will ^ Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and
say(s) that she / he I they was /were present and saw the above Testator !Testatrix sign the same
and that she / he /they signed the same and that she / he /they signed as a witness at the request of
the T tator /Testatrix in her I his presence and in the presence of each other.
1 ~
~~p ~~
(SignerurcJ igw
~'l~~~iL ~Yi ~ ~~~~~.
(Sereu AddntsJ (S~rterAddrusJ
I )~~.~~I~r{~x ~1~-1» ~.~ i~t1~~ , '~~ 11122
(city, Stase, zip) ~ (City. Sense, Ztp)
Executed in Register's Office
Sworn to or affirmed and subscribed
before me this day
of
Executed out of Register's Office
Sworn to or affirmed and subscribed
before me this a ~ day
of ~0 y-e~hn-J oZO)~
Deputy for Register of Wills Votary Public CpMMONWEAl7H of m!~.l
:~Iy Comrission Expires: Notarial seal
(Signature and Sal of Notuy as other otTici 7 SudiS$tlafpN D. Endo Notary Public
administc: cuW. Shaw daM O[expintiono Nou01b#06n8aWn1)'tD•, Lancaster County
My Commissfon Expires Feb. 11, 2015
MEMBER, PENNSriVANU AS$OQATION OF NOTARIES
NOTE: To be taken by Ofrmer authoriud ro edminfstar oaths. Pleau have proem the original orcopy of insuument(s) m time o[natariution.
Forn: R W-03 rev. !0.13.06