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PETITION 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: Edward K. Lank File No: ~ ~ - ~ ~ - ~ p~c~
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No:
Date of Death: November 19, 2012 Age at death: 87
Decedent was domiciled at death in Cumberland County, pennsylvania (scare) with his/her last
principal residence at 593 Locust Lane. Mechanicisbure. PA 17055 Uoaer Allen Township Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at Homeland Center. 1905 S. 5th Street. Harrisbure 17102 Harrisbure Citv Dauphin PA
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 $ 370,000.00
If not domici/ed in Pennsy/vania ........................ Personal property in Pennsylvania $
/f not domici/ed in Pennsylvania ........................ Personal property in County $
Value ojreal estate in Pennsylvania ......................................................... $
TOTAL ESTIMATED VALUE.... $ 370.000.00
Real estate in Pennsylvania situated at:
(Attach additional sheers, ijnecessarv.) 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 November 17, 1994 and Codicil(s)
thereto dated NONE
State relevant circumstances (eg. renunciation, death ofexecuror, 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 bom or
adopte d Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person.
O EXCEPTIONS Q 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, durance absentia, durance minoritate
If Administration, c.t.a. or d.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(8) and was neither the victim of a killing nor ever adjudicated an incapacitated person.
Q NO EXCEPTIONS Q EXCEPTIONS
s ~ .... ~
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the follo~tg~ouse (if ate and ~rsgbttach
additional sheets, if necessary): t>4 p ~~~ OO
f7'1 -~ r. C [Y! ~
Name
Relationshi ...
Ad siCZ t'ti ~ ~
~ x O O
Q ~ ~ ~
O C ~ ~ ~
~ Cf'1 (! O
A
FormRW-02 rev. t0/l!'?01t Page 1 oft
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
}
} ss:
}
COUNTY OF Cumberland
Official Use Only
RECORDED OFFICE 0~'
REGISTER OF W1~LS
Petitioner(s) Printed Name Petitioner(s) P ' s
Andrew E. Lank 8 S ri noli Lane Enola PA 17025-2939
ORP
~Il:BERLANQ CO,, AA
The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and correct to the best ofthe knowledge and belief
of Petitioner(s) and that, as Personal Representative(s) of the Decedent, t Petitioner(s) w' I well a truly administer the estate accord~ing~tJo law.
Sworn to or aff rmed and subscribed before ~ ~,r _ Date ~~'"`~`°~
met ' day of 2 Date
>~y: Date
For rh~r Register Date
BOND Required: Q YES Q NO To the Register of Wills:
FEES: Please enter my appearance by my signature below:
Letters ...................... $ . W
( 5) Short Certificate(s)..... .
( )Renunciation(s)........ .
( )Codicil(s) ............ .
( )Affidavit(s)........... .
Bond ........................
Commission ................. .
Other ........
~9.) 1 ~ I ........ 15.0
Automation Fee ...............
JCS Fee ..................... U
TOTAL ..................... $ 50
Attorney Signature:
~J.~~A j
Printed Name: Vicky Ann Trimmer, Esq.
Supreme Court
ID Number: 49679
Firm Name
Address:
Phone
Fax:
Email:
Persun & Heim P.C.
(717)620-2440
(7171620-2442
vatrimmer(a)nPrcunhPim rnm
DECREE OF THE REGISTER
Estate of Edward K. Lank File No: ~' ~ ' ~ a- - ~ ~ 3 d
a/k/a:
AND NOW, ~~~~ IM,~.f' a~ , ~ (~, in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Andrew Edward Lank _
in the above estate and (if applicable) that
the instrument(s) dated November 17, 1994
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent
Register of Wills ~ r ~~„ nn s n/J ~
Fornt RW-02 rev. 10;71!?0!! V~-~~C1 Page~2-xo..f 2
_ __ _ ___
HIOS.NQS REV r9rl I1 - - - --- - --- _.
LOCAL REGISTRAR'S CERTIFICATION OF~ DEATI~~
WARNING:. At is illegal to duplicate this copy h>~, photostat ar phcstograpl^+,
Fee. for this certificate. `~6.()() RECORDED a~rICE OF
RE~S•E~Z-~~ ~~ ~r~.~.5 I~iZ}t~7k~~r,,,, l )I I, II )i)~ in ~ ±i1i i)~~fix-nistjon h~rc ~,nen )s
iii,~~ ~~ ~~~. `~ )) ~.Il\ i}l1CCl 1 );.1 ,tl lifl_..lH~tl ~~er[ItIL:1fl' Vt ~eath
Q ppi~pp ('~ [ C`~~ ~ ~_,1 tell ~i~e(f N'lllj I i (('~i~ ~ct 1Strar. ~he t?Il~ln~ll
f~I? ~~~ 28 ti!! J J~ ~:i~~~~'~.~~~1 I-' irliirat( ~I~i ~~ ,~~zi;~Gcc1 to the State Vital
o '
vi '` 2a ~~ }`; I n~(l`. i i . (' it C:!liitl!CnI fllln~`.
CLERK a~ ~*F ~
- .. -- ~ a N s c a u RT ~ hI~F~T a `~ ~~~ ~%~ - - NOV ~ 0 2~ _-_
- ----- --- -
Cert)tir,ation Number ~`~,,,,,,_,._.. -"----
~:~ERLAND ca., PA l )~~~~,~ l2: ,~~~)~..) l~<(te lssHeul
Type/Print In COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH ~ VITAL RECORDS
Permanent
1. Decedent's Legal Name (First, Middle, Last, Suffix) v r ~ z t z State Flle Number:
2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yrj (Spell Mp)
Edward Klugh Lank
male 183-~2-1594 ov_~g 2 ~
Sa. Age-Last Birthday (Vrs) Sb. Vnder 1 Vear Sc
Under 1 D
.
a 6. Date of Birth (MO/Day/Near) [Spell MOnih) ]a. Birthplace (City and State or Foreign Country)
8 7 MonThs Days Hours Minutes
H
March 29, 1 925
]b. Birthplace(COUnty) Dau bin
Sa. Residence (State or Foreign Country) 8b. Residence (Street and Number- Include Apt No
) 8c
Dld D
d
.
.
ece
ent Llve in a Township?
Penn X593 Lo~us~ Lan Ves, decedent lived in Upper A11en
8d. Residence (Count
) Beh
~
'
y
an es ur
1 7 O 5 5 twp,
A
Cumberland
'
ae. Resld¢n~e (zip cpd¢> ~
7 O 5 5 ONO, decedent IWed within limits of
city/born.
.Ever In US Armed Forces? 30. Marital Status at Time of Death Q Married Widowed 11
Su
i
i
'
.
rv
v
ng Spouse
s Name (If wife, give name prior to first marrlageJ
Yes Q No Q Vnknown ~ Divorced Q Never Married Q Unknow
12. Father's Name (Firs[, Middle, Last, Suffix)
13. Mother's Name Prior to First Marriage (Firs[, Middle, Last)
O_B_ Lank
Ruth Viola Lavender
14a
Inform
t'
N
.
an
s
ame 146. Relationship to Decedent 14c. Informant's Mailing Address (Street and Number
City
Andrew E
State
Zl
C
d
Lank
G ,
,
,
p
.
o
e)
son
8 Sgrignoli e,
2n0
......
PA 1 7 0 2 5
s ................................................ .... ...................................... ~.f D .. lhaO P ace.
.. ec on y one
cat... .
If pea[h Occurred In a Hospital: t~ Inpatient I
.
...°""-"...........an _..° ..
a
"
a
..°--..
...............
¢ t <curre
d 5
_ pmewhere orn
' er Than Hospital: ~' Hospice Facility ~~""""'"""""""""""""
LJ Decedent's Home
Q Emergency Room/OUtpatlent 0 Dead on Arrival Nursing Home/Lon
-T
C
g
erm
are Facility Other 5
i5 b. Faclllty Na mellf not institution, glue street and number; SSC. City or Town, State, and Zlp Code ( Pecify)
Hom
l
d
e
an
pA ~ ~~ O2 SSd. County of Death
Center Harrisburg
m ,
Dau
bin
16a. Method of Disposition Q Burial Cremation 16(s
Dale
f Dl
.
o
s
Q Removal from State Q Donation Position 16c. Place of Disposition (Name of cemetery, crematory, or other place)
'~' Other (Specify) Nov. 21 , 20'I 2 Hollinger Crematory
2 16d. Location of Disposition (City or Town, 5[at¢, a d 21p) ignature of Fu t Service Li
~ ce r Person In C~terment 1]b. License Number
Mt.Holly Springs,PAl 7065
y
~ L
D-O'f 3'I 63-L
E 1]e. Name and Complete Address of Funeral Faclllty
8 Musselman FH&CS 324 Hummel Ave em
~ o n
18. Decedent's Education -Check the box [hat 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 that best describes whether the deced
t
h
en
t
e decedent considered himself or herself to be.
Q 9th grade or less is Spanish/Hispa nlc/Latino. Check the "N O" White Q Korean
Q No diploma, 9Th - 12th grade b
ox If decedent is not Spanish/Hispanic/Latino. Q Black or African American Q Vietnamese
Q High school graduate or GED completed
Q No, not Spanish/Hispanic/Latino Q American Indian or Alaska Native ~ Other Asian
~ Some college credit, but no degree Q Ves
Mexica
M
,
n,
exican American, Chicano Q Asian Indian Q Native Hawaiian
~s~ elate degree (e.g. AA, q5) Q Yes, Puerto Rican Chinese
a helor•s degre
(e.g. BA, AB
BS)
Q Guamanian or Ch
Q
~
,
amorro
Q Yes, ouban
Q Master's degree ( .g. MA, MS, MEng, MEd, MSW, MBA Q Filipino
O Samoan
O Ves
ther5
ani
h/Hi
,
p
s
c/Latino
spa ni Q Japanese Q Other Pacific Islander
Q Doctorate (e.g. PhD, EOD) or Professional degree
(Specify) Q Other (Specify)
. MD DOS DVM LLB JD
21. D cedent'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
White 0 Japanese
e of
k
t
wor
YP
0 Samoan done Burin g
01ack or African American Q Korean Q Other Pacific Islander g most of workin life. DO NOT USE RETIRED.
0 American Indian or Alaska Na[IVe Q Vietnamese ~ Don't Know/Not Sure de s i gne r
Q Asian Indian Q Other ASlan Q Refused
Q Chinese Q Native Hawaiian Q Other (Speci 22b. Kind of Business/Industry
ty)
~Fllipino QGUamanian or Chamorro
kl tchanS
gY PERSON WHO PRONOUNCES OR ED 23a. D ~enPro`n~ Dea Mo Day Yr 236. Signature o Person Pronouncing Death (Only when applicable) 23c. LI<ense Number
CERTIFIES DEATH sc.~! ~ 1 Q a /1 Lj
~
~ ~~~
23 pate Signe (MO/Day/Vr
24
Time of D
A
f
~
-
/f
~
-
~
~/
~ ~~~~
^
.
eaf
~(
l
f
f C
J s"
~ ~
~
Q `J ~
(Y'7 25. Was Medical Examiner o r Contacted?
orone
es
No
CAUSE OF DEATH
26. Part 1. Enter the chain of events--diseases, Injuries, or compllcatlons--that direct) pprox
A ima[e
Y caused the death
DO NOT
.
respirafo r v
enter terminal events such as cardiac arrest Interval:
ry arrest, o entricular fibrillation wlthput showing t tiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary •
/ Onset i0 Death
IMMEDIATE CAUSE ---------------~ a. ~(~~ T~QIt
(Final disease or condition
Due to (or
resulting in death) as a consequence of);
b.
Sequentially list conditions'
Due to (o sequence of):
If any, leading to the c r as a con
¢
listed on line a. Enter che
UNDERLYING CAUSE
Due to (or sequence f
(disease or injury that as a con o )
F initiated the events resulting d.
~ In death) )AST.
Due to o as a con -
( r sequence of):
26. Psrt 11. Enter other signiFlCant ditl ib tl t d th resul
g In the under yin
caus
i
~
g
e g
ven in Part i
~j'^ ' sl 2]. Was an autopsy perfprrr~p~'+
/G /~~'S //t ~ f T >~/ G- ~,~/fAS Jul ~VG< Q Yes @~~
~' / 28. Were autopsy findings available
G~/'~
r~a,~L
to complete the cause~~
th?
/
_
a
29, If Female: 30
Q Yes ~iHp
Did T
b
E .
o
acco Use Contribute io Death?
Q Not pregnant within past year
31. Ma r of Death
~ y~~/
Q Probabl
Q Pregnant at time of death
,_,~e' V Natural Q Homicide
!T"+o
Q Not pregnant, but Q Unknown Q gccident p Pending Investigation
pregnant within 42 days of death
ti Suicide
Q Not pregnant, but pregnant 43 days to 1 year before death 32
Q ~ Could not be determined
Date of In
.
jury (MO/Day/Vr) (Spell Month)
Q Unknown If pregnant within the pas[ year
33. Time of injury
34. Place of Injury (e.g. home; construction site; farm; school)
35. Location of InJury (Street and Number, CI
ty, State, Zip Code)
36. Injury at Work 37. If Transportation Injury, Specify:
39. Describe How In
Q jury Occurred:
O
r
t
Q
r
pe
a
or Q Pedestrian
Q NO
Passe
n
Q ger ~ Other (Specify)
39a. Ifler (Check only one):
Certifying physician - To the best of my knowledge, death o c red due to the cause(s) end m ted
Q P
ronou n<ing ga C¢rtlfVing physician - To the best of my knowledge, death occurred at the Time, date sand place
and due to the
Q Medical Examiner/C
,
cause(s) and manner stated
oroner - the basis of examin to and/or Investigation, In my opinion, death oc red at the e
d
t
r m
,
a
e, and place, and due to the cau
se(s) a d
m
an staled
Signature of certifier:
3 A
/
Title of certifier:
s
/ License Numb¢r:
~!/~Gp J ~~L
9b
a
Add
_
.
me,
ress and Zip Cod of Poison Completing Ca e f Dea h (Item 26)
If ~~ ~~ `` /~ 39c. Dat¢ 5ignetl (MO/Day/Yr)
4 0. Registra is District Num er 41. Registrar's ature
~i~ '7/~ 42. Registrar File Date (Mq ay r)
O/
4 3. Amendments
~~/~ ~j/' a~ ~ 3~
Disposition Permit No. v S I ~ / // H105-143
REV 0]/2011
~ S • ~ • I
~itts# i~C ttx~b ?~Ges#nue~t
of
EDWARD K. LANK
rn~~ ~ ~~
y. t- rv
~z~ oa ~ rn
%~~
v
'
ac cs ~
~
-
I, EDWARD K. LANK, a resident of Pennsylvania, Cumberlai~! ~~aty, ~ingBf ;~
sound mind, memory and understanding, do hereby make, publish and de~aac t~i'at this is i~~
Last Will and Testament. ~ ~ `~ r- ~
~ u-ti
crt to ~
FIRST: I revoke all wills and codicils that I have previously made
SECOND: I am currently married.
THIRD: As used in this will, the term "specific bequest" refers to all specifically
identified property, both real and personal, that I give to one or more beneficiaries in this
will. The term "residuary estate" refers to the rest of my property not otherwise specifically
disposed of by this will or in any other manner. The term "residuary bequest" refers to my
residuary estate that I give to one or more beneficiaries in this will.
FOURTH: All personal property I give in this will through a specific or residuary
bequest is given subject to any purchase-money security interest, and all real property I give
in this will through a specific or residuary bequest is given subject to any deed of trust,
mortgage, lien, assessment, or real property tax owed on the property. As used in this will,
"purchase-money security interest" means any debt secured by collateral that was.incurred
for the purpose of purchasing that collateral. As used in this will, "non-purchase-money
security interest" means any debt that is secured by collateral but which was not incurred
for the purpose of purchasing that collateral.
FIFTH: When this will states that a beneficiary must survive me for the purpose of
receiving a specific bequest or residuary bequest, he or she must survive me by 5 days.
SIXTH: I hereby leave my entire residuary estate to be shared equally among my
children, per stirpes with representation.
SEVENTH: Any specific bequest or residuary bequest made in this will to two or
more beneficiaries shall be shared equally among them, unless unequal shares are specifically
indicated.
Initials: 4 ~ ~ Date: t 1 `17 ~ Page 1 of 4
..
Will of EDWARD K. LANK
EIGHTH: I name my wife, NANCY B. LANK as my personal representative
(executrix), to serve without bond. ffmy executrix can not serve for any reason, I name my
son, ANDREW LANK as my executor to serve without bond.
NINTH: I direct my personal representative to take all actions legally permissible
to have the probate of my will done as simply and as free of court supervision as possible
under the laws of the state having jurisdiction over this will.
TENTH: I hereby grant to my personal representative the following powers, to be
exercised as he or she deems to be in the best interests of my estate:
1) To retain property without liability for loss or depreciation resulting from
such retention.
2) To dispose of property by public or private sale, or exchange, or otherwise,
and receive and administer the proceeds as a part of my estate.
3) To vote stock, to exercise any option or privilege to convert bonds, notes,
stocks or other securities belonging to my estate into other bonds, notes,
stocks or other securities, and to exercise all other rights and privileges of
a person owning similar property.
4) To lease any real property that may at any time form part of my estate.
5) To abandon, adjust, arbitrate, compromise, sue on or defend and otherwise
deal with and settle claims in favor of or against my estate.
6) To continue or participate in any business which is a part of my estate, and
to effect incorporation, dissolution or other change in the form of
organization of the business.
7) To do all other acts which in his or her judgment may be necessary or
appropriate for the proper and advantageous management, investment and
distribution of my estate.
The foregoing powers, authority and discretion granted to my personal representative
are intended to be in addition to the powers, authority and discretion vested in him or her
by operation of law by virtue of his or her office, and maybe exercised as often as is deemed
necessary or advisable, without application to or approval by any court in any jurisdiction.
ELEVENTH: Except for purchase-money security interests on personal property
passed in this will, and deeds of trust, mortgages, liens, taxes and assessments on real
property passed in this will, I instruct my personal representative to pay all debts and
expenses, including non-purchase-money secured debts on personal property, owed by my
estate as provided for by the laws of Pennsylvania.
Initials:~~, Date: I 1 l7 ~Lf- Page 2 of 4
Will of EDWARD K. LANK
TWELFTH: I instruct my personal representative to pay all estate and inheritance
taxes assessed against property in my estate or against my beneficiaries as provided for by
the laws of Pennsylvania.
I, EDWARD K. LANK the testator, sign my name to this instrument, this (~ day of
1Ve~v~..,b~ , 1994. I hereby declare that I sign and execute this
instrument as my last will, that I sign it willingly, and that I execute it as my free and
voluntary act for the purposes therein expressed. I declare that I am of the age of majority
or otherwise legally empowered to make a will, and under no constraint or undue influence.
~, _
(Signed)
We, the witnesses, sign our names to this instrument, and do hereby declare that the
testator willingly signed and executed this instrument as the testator's last will.
Each of us, in the presence of the testator, and in the presence of each other, hereby sign
this will as witness to the testator's signing.
To the best of our knowledge, the testator is of the age of majority or otherwise legally
empowered to make a will, is mentally competent, and under no constraint or undue
influence.
Wye declare under penalty of perjury, that the foregoing is true and correct, this
1~_- day of ~ ~ ~L~ , 1994.
Witness #~~ y+~--Residing at: ~$ ~e~ '~_ ~,,,
Witness #2: Residing at: 3 `~G d~9ll ~ ~.~fw~ ~~,,,,,~
Initials: ~~; Date: i ~ 117 ~ ~ Page 3 of 4
Will of EDWARD K. LANK
AFFIDAVIT
~W.,e, EDWARD K. LANK, `~~~c~.~~ ~.-. - ~~~~,aµ.~ . and
~_[~eG~~ _ ~ - ~ ,the testator and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument in those capacities, personally
appearing before the undersigned authority and being first duly sworn, declare to the
undersigned authority under penalty of perjury that:
1) the testator declared, signed and executed the instrument as his last will;
2) he signed it willingly or directed another to sign for him;
3) he executed it as his free and voluntary act for the purposes therein expressed; and
4) each of the witnesses, at the request of the testator, in his presence, and in the presence
of each other, signed the will as witness and that to the best of his knowledge the testator
was at that time of full legal age, of sound mind and under no constraint or undue influence.
Testator: ~ ~.
~^
Witness: ~.~_ ~-~
Witness:- ~----T
Subscribed, sworn to and acknowledged before me by EDWARD K. LANK, the
testator, and b~~1J0.~~~ L .~~'~....•_-.and r'+~~~~, ~'~'t~,..._
witnesses, this ~_ day of N~v~ ___, 1994.
~~9 `~/.
N
Notarial Seal
Michele J. Hartman, Notary Public
Lemoyne Boro, Cumberland County
My Commission Expires Aug. 3, 1998
Member, PerrsyNarraAssociatan of Notaries
Initials: 1~; Date: t ` t ~ ~ ~ Page 4 of 4