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HomeMy WebLinkAbout12-12-12 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: Erma A. Morrow File No: 21 a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 202-20-0605 Date of Death: 12/6/12 Age at death: 85 Decedent was domiciled at death in Cumberland County, Pennsylvania (State) with his/her last principal residence at 35 East Gate Drive, Apt. 202 17015 Carlisle Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 366 Alexander Spring Road 17015 Carlisle Cumberland 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 $ 15,000.00 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.... $ 15,000.00 Real estate in Pennsylvania situated at: (Attach additional sheets, ifnecessaty.) 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 4118/02 and Codicil(s) thereto dated None. State relevant circumstances (e.g. renunciation, death ofexecutor, 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. ® 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.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(g) and was neither the victim of a killing nor ever adjudicated an incapacitated person. ❑ NO EXCEPTIONS ❑ EXCEPTIONS - = © r1l Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the foll~n+r~~~pouse (if anclLbir f ttach additional sheets, if necessary): rn C-D ~ n Cl9 :."D Name Relationship dtd&s3u fu --r C e " Ci 7-3 "J f ..~1 a Lt`1 rl Form RW-02 rev. 10/11/2011 Page I of 2 Oath of Personal Representative Official use only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Petitioner(s) Printed Name Petitioner(s) Printed Address 2200 Canyon Drive, Unit E1 Gwendolyn Strom Costa Mesa A 5%9 cC-) Cl) ::a En n _4 C3 r M cn ry el s 2! rt-t The Petitioner(s) above-named swear(s) or affirm(s) the statements in the foregoing Petition are true and correct to the t6st ethe known an el of Petitioner(s) and that, as Personal Representative(s) of the Decedent the Petitioner(s) will well and truly administer The estate accordMto law. -n Sworn to or affirmed and subscribed before 1" 101 I Date me , Lrit [lay o ' J , 211 1 _ Date By: N uh ~ 1_'L Date For the Regisier ( Date BOND Required: ❑ YES ® NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters $ Attorney Signature: O Short Certificates(s) r~ Lj ' ( ) Renunciation(s) ( ) Codicil(s) l/ ( )Affidavit(s) Bond Printed Name: Seth T. Moseb s uire Commission Supreme Court Other . , , , , ID Number: 203046 . ~h L'( Firm Name: Martson Law Offices Address: 10 East High Street C~ . ' ' ' ' ' ' ' ' Carlisle PA 17013 Phone: (717) 243-3341 Fax: (717) 243-1850 Automation Fee Email: smosebey(a,martsonlaw.com JCS Fee TOTAL 5 1 DECREE OF THE REGISTER Estate of Erma A. Morrow File No: 21 T a/k/a: AND NOW, Cx0 in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary are hereby granted to Gwendolyn Strom in the above estate and (if applicable) that the instrument(s) dated April 18, 2002 _ described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. d '4a I n Lzjh a IL Register of Wi ls~ Form RW-02 rev. 1011112011 fi 4 - _age- 2 IilU~.80.5 RliA" Willi LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, ,)6.00 RECORDED O'FFiCE OF GFp "lhi" is to certily that the information here given is 11 ~ 1 REG(ST R OF ~ c, tjectk copictl from an original Certificate oi'Death & \ duk fi!cd with me as Local Registrar. The original c(rtificate will be forwarded to the State Vital tli2 DEC 12 M I R c(trd~ Office for permanent filing, P 18 8 8 413 5 CEEFIK Or. - L1 dC s/2012 ENS 0 - C J U R T Certification Number O R P H A M S' - Local Re-isnar Date Issued Type/Print 1, GUMBERCo mm (~y(/J~~{A .If/ CJF~k1 PENNSYLVANIA DEPARTMENT OF HEALTH _ VITAL RECORDS Permanent Black Ink CERTIFICATE OF DEATH State File Number: 1. Decedent's Legal Name (Firs[, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Yr) (Spell Mo) Sa. Age-Last Birthday (VPs) 5b. Under 1 Vear 5c. Under 1 Da 6. Date of Birth (MO/Day/Vea P) (Spell Month) 71. Birthplace (City and State or Foreign Country) Months Y. Hours Minutes 7b. Birthplace County) Sa. Residence (State or Foreign Country) 8b. Residence (Street and Number - Include Apt No.) gr., id Decedent Live In a Township? Pa. 1~Yes, decedent lived In s Nrt d d 1 Q t o n -P. 8d. Residence (County) 3 5 East Gate A t 2 0 2 8e. Residence (Zip Code) -1 -7 n I E3 No, decedent lived within limits of city/boro. 9. Ever in US Armed Forces? 10. Marital Status at Time of Death - Married E3 Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage) Q Yes 54 No Q Unknown Divorced JR Never Married E3 Unknown 12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last) Robert Morrow M r B. Bo r 14a. Informant's Name 14b. Relationship to Decedent 14c. Informant's Malting Address (Street and Number, City, State, Zip Code) O G 15a: P ace o Deat... C ec on y one If Death Occurred in a HosPita l: Inpatient : itf Death Occurred Somewhere Other Than a Hos Pitai tJ Hospice Facility t_I Decedent's Home ~ Q Emergency Room/Outpatient 0 Dead on Arrival Q Nursing Home/Long-Term Care Facility Q Other (Specify) °d 15b. Facility Name (If not institution, give street and number; a City or Town, State, and Zip Code 15d. County of Death Carlisle Re Tonal Mac] rlisle Pa 17013 Cumberland 16a. Method of Disposition lit] Burial 0 Cremation 16b. Date of Disposition 16c. Place of Disposition (Name of cemetery, crematory, or other place) p R._ frpm scare El Donation 2/10/12 Cumb_ Va11 ey Mem Gdns omen (specify) 16d. Location of Disposition (City or Town, State, and Zip) 17a. Sign of F neraI rvice Licensee or Person in Charge of Interment 17b. License Number Carlisle, Pa 17013 FD 13895 0 17c. Name and Complete Address of Funeral Facility 16. De<e ent's Education -Check the box that best describes the 1 Dece eni of His anic Origin - Check the 20. Dece ent's Race - Check ONE OR MORE races to indicate what P- highest degree or level of school completed at the time of death. box that best describes whether the decedent the decedent considered himself or herself to be. Q 8th g"d or less Is Spanish/Hispanic/Latino. Check the "No" White Q Korean No diploma, 9th - 12th grade box if cecedant Is not Spanish/Hispanic/Latino. E3 Black or African American Q Vietnamese High school graduate or GED com Pieter No, not Spanish/Hispanic/Latino American Indian or Alaska Native Other Asian Some college credit, but no degree Yes, Mexican, Mexican American, Chicano Asian Indian 0 Native Hawaiian Q Associate degree (e.g. AA, AS) Q Yes, Puerto Rican E3 Bachelor's degree (e.g. BA, AB, BS) Yes, Cuban E3 Chinese EJ Guamanian or Ch, mono Filipino Master's degree (e.g. MA, M5, MEng, MEd, MSW, MBA) ~ Yes, other Spanish/Hispanic/Latino E3 Japanese Q OtheraPaciflc Islander Doctorate (e.g. PhD, Ed D) or Professional degree (Specify) Other (Specify) . MD DDS, DVM LLB, JO 21.W. D cedent', Single Race Self-Designatlon - Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation - Indicate type of work hite E3 Japanese M Samoan done during most of working Iife. DO NOT USE RETIRED. 0 Black or African American 0 Korean Ej Other Pacific Islander American Indian or Alaska Native Vietnamese Don't Know/Not Sure m ndo a eh i n e o e r a t o r )3 Asian Indian Q Other Asian Refused 22b. Kif Business/Industry Q Chinese 0 Native Hawaiian Q Other (Specify) Q Filipino C3 Guamanian or Chamorro E-1 e c tr is Business ITEMS 23. - 23d MUST BE COMPLETED 23a. Date Pr / ad (MO/Day Vr) 23b. Signature of Pe P clf+k ath (Only when applicable) 23c. license Number BY PERSON WHO PRONOV NOES OR O~Ce~' CERTIFIES DEATH 23d. Date Si ~M y/Yr) 24. f Death Y// S V(/ Z-d 25. Was Me cal Examiner Coroner Contacted? 0 yes No CAUSE OF DEATH Approximate 26. Part 1. Enter the chain of events--diseases, injuries, or complications--that directly ,used the death. DO NOT enter terminal events such as cardiac arrest Interval: respiratory arrest, or ventricular fibrillation without showing the/et)iol,gy. DO NOT/ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary Onset to Death IMMEDIATE CAUSE a. (Final disease or c.Eh--------------- ndition Poe to (o as a cons quence of): - resulting in death) Sequentially list conditions. Due to (or as a consequence of): Of.", leading the -u- listed on Tine a . . Enter the UNDERLYING CAUSE Due to (or as a con (disease or injury that seq uence of): I. itlated the events resulting d. In death) LAST. Due to (q as a consequence of): S 26. Part 11. Enter other significant conditions contributing t death but not resulting in the underlying cause given in Part I 2J. Was an autopsy perfomed? ~ p Ves 8'- 26. Were autopsy Flndings available plete the cause of death? ~ to coO Ves 29. If Female: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death E Not pregnant within past year M Yes Q Probably ~ Natural Q Homicide S E3 Pregnant at time of death CA No j:1-Unknown 0 Accident Pendin invest) 0 Not Pregnant, but pregnant within 42 rays of death Suicide g gatimi ti Q Not pregnant, but Pregnant 43 days to 1 year before death 32. Data of Injury (Mo/Des /Yr S 0 Could not be determined E:] Unknown if pregnant within the past year Y ) ( Pell Month) 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: Q Yes ~ Driver/Operator 0 Pedestrian 0 No 0 Passenger 0 Other (Specify) 397 Certifier (Check only one): _Ce-rt-ifying physician - To the best of my knowledge, death occurred due to the c use(s) and manner stated _i.RPronouncing g. Certifying physician - To the be my knowledge, death occurred at the time, date, and place and due to the cause(,) and manr stated Medical Examiner/Coroner - On t ba mination, and/or investigation, in my opinion, death / thoccurred at the time, date, and place, and due to thJQ~~ ( ) d -,"net stated Signature of certifier: Title of certifier: / / . 42 License Number:J / '7 L 96. Natne, Addr~ Zip Code of Per Completing Causes of Death (item 26) F39c ig r) 4 0. R,gg(,ttrr,r's District Number 411- ra rDay Vr) . D 43Amendments O Q q~~( H70 69-143 Disposition Permit No. 1. REV 07/20 7-143 FABLEMATAFILEEstate Planning\10610-will RECORDE ? ! " C LAST WILL AND TESTAMENT REGIS° e or-, r _ S I, ERMA MORROW, of West Pennsboro Township, Cumber s Fo y Pe ylva~i , being of sound and disposing mind and memory, do hereby make, publish and declare this to be my CLERK C _ Last Will and Testament, hereby revoking any and all former Wills or Cocbo y-xie cue, I. CUMBERLAND C, I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My personal representative 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. 2. I give, devise and bequeath all of my estate, both real and personal property, unto my daughter, GWENDOLYN STROM, absolutely. 3. 1 nominate, constitute and appoint my daughter, GWENDOLYN STROM, as Executrix of my estate. 4. I direct that my Executrix shall not be required to file a bond to secure the faithful performance of her duties in any jurisdiction. 5. I authorize and empower my personal representative, in her sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as she may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to j oin in or secure the partition of same; to compromise any claims or demands [initials Page I of 3 Pages of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my personal representative considers desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my personal representative shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. IN WITNESS WHEREOF I have hereunto set my hand and seal this day of (SEAL) Erma Morrow SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our names as witnesses ther to, in the presence of the said Testatrix and of each other. 9 Page 2 of 3 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) We, Erma Morrow, ~12111y' z 0 and r Ix~ r a,-~ . (x )r 1'(~.(~ the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will and that the Testatrix has signed willingly, and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. x itness itness Subscribed, sworn to and acknowledged before me by Erma Morrow, the Testatrix, and subscribed and sworn to before me by Del V iG and e(A c- , the witnesses, this rl - y , Ada of 2002. Notary Public NOTARIAL SEAL CORRINE L. MYERS, Notary Public Carlisle Boro, CumberlandCoun My Commission Expires Ma 27, 2003 Page 3 of 3 Pages