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HomeMy WebLinkAbout01-08-13Reset 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: Vance L. Kitner, Jr. File No• ~ ~ - ~ `- ~C~2 a/k/a: a/k/a: a/k/a: Date of Death: July 18, 2012 (Assigned by Register) Social Security No: Age at death• 64 Decedent was domiciled at death in Cumberland County, pennsylvania (state) with hislher last principal residence at 4 Wilbert Drive. Carlisle, 17013 North Middleton Cumberland Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 4 Wilbert Drive. Carlisle, 17013 North Middleton 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 $ If not domiciled in Pennsy!vania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................ Personal property in County $ Value of real estate in Pennsylvania ...................... ................................... $ 24 10(1.00 TOTAL ESTIMATED VALUE.... $ , 24.100.00 Real estate in Pennsylvania situated at: 402 Mountain View Road Mt. Holly Springs 17065 Dickinson Cumberland (Attach additional sheets, if necessary.) 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 July 3, 2012 and Codicil(s) thereto dated n/a State relevant circumstances (e.g. 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. 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 db.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 Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived b the lowin s ou y ~e g p se.~if any~n~us (attach additional sheets, if necessary): Q t7 Name Relationshi ~d ~~.. •~~~ iR.a ~. ~ ~, ~ CEO ~" ~ ~~ ~,t _, n _..~...7 ~... T.,t ~ ,, ~y . ~ F'_'. i.... V (~i 1 r'+J y r ~.y p~ I Form RW-02 rev. 10/!!/2011 Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } } SS: } Petitioner(s) Printed Name Petitioner(s) Printed Address .. Doris K. Kimer 'Ul ~ 'I~~ ~ ,' ..1 ~ 4 Wilbert Drive Carlisle PA 17013 VRI ~A~V' S.SVU~L~ CUMBERL ~~'~ ~~,, ~~ 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 th?t, as Personal Representative(s) ofthe Decedent, the P ' 'oner(s) will well and truly administer the estate according to law. S~3~orn to or affirmed a d subscribed before ~ Date ~/-D ~ - / ~ me t _~___ day of ~ ~ Date ~~~ /' ,I~~i, By Date For the Register Date BOND Required: ~ YES ~ NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters ...................... $1,J"lJ (~ )Short Certificate(s)...... ~~ ( )Renunciation(s)......... e ( )Codicil(s) ............ . ( )Affidavit(s)............ . Bond ............. . ......... . Commission ................. . Other .,..,,,, ~,~~ ....... G v . ~nv~n ;r :::::::: i., Automation Fee . ............. . JCS Fee . .................... ~ - ~-'G'' TOTAL ..................... $ ~ ~ -C~ ~- Attorney Signature: Official Use Only a ;- Printed Name: Adam R. Deluca, Esq. Supreme Court ID Number: 311738 Firm Name: Allied Attorneys of Central Pennsylvania, LLC Address: 61 West I.outher St. .Carlisle, PA 1701 ~ Phone: Fax: Email: 717-249-1177 717-249-4514 ardelnraRSna~Lcnm DECREE OF THE REGISTER Estate of _Vance L. Kimer, Jr. File No: ~ ~ - (,~ - ~_(~ a/k/a: AND NOW, - ~~~ .~) _, in consideration of the foregoing Petition, satisfactory proof awing been a ented before me, IT IS DECREED that Letters Testamentary are hereby granted to Doris K. Kitner in the above estate and (if applicable) that the instrument(s) dated July 3, 2012 described in the Petition be admitted to probate and filed of record as the last Will (and Coriicil(~)) of I)eced~tt Register of Wills - ~ ~~ ~`" ~~. ~ r ,?~~C~~~.~~~~~ ~ ~l_ Form RW-01 rev. 10/11/2011 ~~ J(~ - ~ Page 2 of 2 H105.80SREV(9/ill _ _ - - - -- - - - - - -- _ _ -._ - -- - LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 ~ E ~ ~ ~ ~ ~ ~ ` ~ i~ ~k ~ ~ This is to certify that the information here given is R E ~ ~ S ~' '~ ~ ~ ~~'" I ~°'-~ correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original i~~33 .;r~~1 $ ~~ l~ ~~ certificate will he for~/arded to the State Vital Records Off~)ce for permanent filing. P 18 6 2 7 ~, ~ c~.~~~ c NAPIS C~Ut~~ L ~x~e.~~ J 1 9 2012 Certification Number CUMBERLAi~~ ~~., PA Local Registrar Date Issued ;~S . Type/Print In COMMONWEALTH OF PENNSYLVANIA • OEPARTM ENT OF HEALTH VITgL RECORDS Permanent v ~_ ~~ ~ yr vG{1 s A State File Number: 1. Deredent's Legal Nam< (First, Middle, Last, Suffix) 2. 5!x 3. Social Security Number 4. Dale of Death (MO/Day/yr) (Spl11 Mo) Vance L• Kitner Jr _ Male 175-40-5009 July 18, 2012 Sa. Age-Last Birthday (Yrs) Sb. Under 1 Year Sc Under 1 O ~ . a 6. Dat< of Birth (MO/Day/YesrJ (Spell Month) 7a 'Ba h p--l~c4 (C it~a nd $tatl o r For<ign Country) 64 Months Days Hors Minutes ~ = g ~ p A SaPtember 2 , 1 947 11 8a. Residence (State or Forel Count 7b. Birthplace (County) um er a pA Bn ry) 8b. Residence (Street and Numblr - Includ! Apt No.) Sc. Dld Decedent Llve in a Town hl 7 s 4 Wilbert Dr. ~(Yes,d<cedentllvedin Nor~Yi Middleton Bd. Residence (County) Cumber 1 and Se. Resident! (Zip Code) Q No, decedent lived within limits of city/born. 9. Ever In VS Armed Forces? 10. Marital Status at Time of Death Married Q Widowed 11. Su rvlving Spouse's Nama (If wife, give name prlo tg first marriage) Q Yes ~ No Q Unknown Q Divorced Q Never Married Q Vnknown D i r or s K Gran Qa 12. Father's Name (First, Middle, Last, Suffix) Ki tner ~ 13. Mother's Name Prior to First Mardage (First, Middle, Last) a< 14a. Informant's Name Bett J_ Lucia 14b. Relationshi to Decedent 14c. Informant's Mailing Address (Street and Numblr Clt St t Zi ~ , y, a <, p Code) 4 Wilbert Dr_ . Car 1 i s 1 , 701 3 a If Death Occurred in a Hos ital: •- -- . gc--on -one P ~ In atienT - .............................. P ~ elf Death O +~ d - ~ ff WI ccurre Somewhere Other Than a Hospital: 1_-1 HOSplce Facili -~ -~--------- - tY ~ Decedent's Home ~ - --~ ' Emergency Room/Outpatient D<ad on Arrival 0 Nursing Nome/Lon -Term Care Facll{ty Oth 15b F ... . er 5 ecl ( P fV) aclllty Nam< (If not institution, give street and number; 15c. City or Town, State, and zip Code 15d 4 Wilbe C t . ounty of Death r Dr • Carlisle PA 17 13 16 M h m a. et Cumberland od of Disposition Q Burial $[ Cremation i6b. Date of DlSposition 16c. Place of DisposRion (Name of cemetery Q Removal from State crem t D , a 0 ory, or other plate<) ona[lon Other (5 e~ify) 7 21 1 2 Hollinger Funeral Home & Crematory 16d. Loeatlon of Disposition (City or Town, State, and Zip) 17a. Signature of Funeral Service Lice s e or Per I Ch 4 son n ar ge of Interment 17b. License Numblr Mt Holt rin '7~"7, S 17c. Name and Complete Add ess of Funeral Facility o nger unera Home & Cre a or 501 N Baltimore v y 2nc ~ _ , 18. Decedent's Education -Check [he box that best describes the 19. Decedent of Hispanic Origin -Check the 20. Decedent's Race -Check ONE OR MORE races to Indicate wh highest degree or level of school completed a[ the time of death box [hat b t < d . a es escribes whether the decedent th decedent considered himself or herself to 6e. Q 8th grade or I<ss IS Spanish/Hispanic/LaTlno. Check the "NO" J~Whi Q N di l o p [e Q Korean oma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. Q Black or African American Q High school graduate or GED completed ~ No, not Spanish/Hispanic/L Vietnamese ti a no Some colleg! Credit, but no degree O American Indian or Alaska Native Q Other Asian Q Ves, Mexican Mexican Ame i h , r can, C icano Q Asian Indian Q Native Hawallan Q Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Bachelor's d< Q Chinese Q Guamanian or Chamorro gree (e.g. BA, AB, BSI Q Yes, Cuban Q FIIIPIno Q Master's degree (e.g. MA, M5, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispanic/Latino Q Samoan Q laps nose Q D t oc orate Q Other PaelflC Islander (e.g. PhD, Ed D) or Professional degree (Specfy) Q Other e. MD DDS DVM LLB JD (Specify) 21. Decedent's Single Race Self-Designation -Cheek ONLY ONE to Indicate what the decedent considered himself or herself to be White 22a Dec d t' . . e en s Usual Occupation -Indicate type of work Q Japanese Q Samoan done duHn Q Black or African American [] Korean Q Other Pacific Islander g most of working life. DO NOT USE RETIRED. Q American Indian or Alaska Native 0 VIltnamese Q Don't Know/Not Sure Stone Mason Q Asian Indian Q Other Asian Refused Q Chinese Q Native Hawallan Q Other (Specify) 22b. Kind of Business/Industry Q FIIiPino Q GuamanlanorChamorro Construction ITEMS 3a - 23 MUST BE COMPLETED 23a. ate Pro ounce Dead (Mo Day r) 23 .Signature of Person Pronouncing Deat Only when ap icab e) 23 BY PERSON WHO PRONODNCES OR Li o c. cens! Number CERTIFIES DEATH O ~ ~- 23d. Da<! Signed Mo/Da /Yr) 24 me of ath Q p _ ~t~// ' ~ y l L /~ F/ sa ~. . d 30 •T, ' • 25. Was Medical Exa or Coroner Contact<d7 Q Yes er No CAUSE OF DEATH 26. Part 1. Enter the chain of even( -diseases, InJu rtes, or complications--that direct) Approximate res irato V caused the death. 00 NOT enter term lnal events p ry arrest or v h t i l Rb , suc en r cu ar as cardla< arrest. Interval: rlllation without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a Ii Add n<. sdd{tlonal Imes if necessary Onset to Death i IMMEDIATE CAUSE -------------> a, Ll+t,1~I V c-JM~I ~~ I µo~~ (Final disease or condition Due to (Or as a cons equence of): resulting In death) b. Sequentially list conditions, Due to (or as a consequence of): if any, leading to the Cause Ilsted on line a. Enter the ~ VNDERLYING CAVSE (disease or injury Thai Oue to (or as a consequence of): - Inl[lated the events resulting d. "c$ in death) LAST. Due to [or as a consequence of): - 26. Part 11. Enter other i)g Ifice [ diti Crib YI t d but not resulting in the underlying taus! given In Part I e ~ 27. Was an autopsy performed7 CQ~ Q Ves Q No ~ 28. Were autopsy Rndings available t g o complete the cause of deathT 29. If Female: Q Yes E No 30. Did Tobacco Use Contribute to Death? Q Not pregnant within past year 31. Manner of Death ' ag ~ Q Pregnant at time of death ®-' I'mo O Probably (~'Fjatural Homicide Q NOt pregnant, but pregnant within 42 days of death Q No Q Unknown Q Accident 0 Q Pending Investlga[lon I- Q Not pregnant, but pregnant 43 days to 1 year before death 32. Date of In u Q Q Could not be detlrmin<d J ry (MO/Da Suicide Q Unknown If pregnant within the past year Y/Yr) (Spell MPnth) 33. Tlm< of Injury 34. Plat! of Injury (e.g. home; construction site; farm; school) 35. Location of Injury (Street and Nu mbar, City, State, ZIp Code) 36. Injury at Werk 37. If Tra nsportatiOn Injury, Specify: 38. Descrlb! How Injury Occurred: Q Ves Q Driver/Operator Q PldesTrian Q No Q Passenger Q Other (Specify) 39a. Gertifler (Check only one): ~C<ertifying physician - To the best of my knowledge, death occurred due <o the cause(s) and m r stated Q Pronouncing S Certifying physician - To the b!s[ of my knowledge, death occurred a[ the time, date, and place, and due to the ~a use(s) and Q Medical Examiner/COrOn h l I e y manner stated s of examination, and/or InvssHgatlon, In my open ion, death oecu rred at the time, date, and place, and due to the cause(s) and manner t d Si e 3 s ate gnature of certifier: Title of certifier: ~p Licens< Numblr: ylVt~~ l`) ~-4' ~p~ ~L--' 9b. Name, Addrcsz and Zip Code of Person Completing Cause of Death (It 26 em ) i^s ICS s r"^'E S KAMFFI'4tJ~'1N t /Mb ~ ~Zl S)r~E-~ll/a~ Kn9A'tp 39c. Data~~sslgned (Mo/Day/Yr) G /Y1[,J~L j l.Io p J4 L'~ o t 3 - 4 s~ 0. Regist 7 ` l 42- rar s District Number 41. Registrar n R` .~` 0 42. Re Istrar FI a Date Mo Day ~ f'y ~ ~ r 4 ` 3. Amendments ( -\ ~O` ~ Disposition Permit No. l J 1 ~ Tt ~ ~ ~ H305-143 REV 07/2011 .. - LAST WILL AND TESTAMENT OF VANCE L. HITNER I, VANCE L. KITNER, of Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils. 1. I direct that all my just debts, funeral expenses, and administrative expenses shall be paid from my estate as soon as practicable after my death. It is my wish that upon my death my body shall be cremated and my ashes shall be buried at Cumberland Valley Memorial Gardens Cemetery, Carlisle, Pennsylvania. 2. I give, devise, and bequeath all of my real property and personal property that I own at the time of my death to my wife, Doris K. Kitner. 3. Should my wife, Doris K. Kitner, predecease me, I give, devise, and bequeath all of my real property and personal property that I own at the time of my death to my son, Vance L. Kitner, III. 4. I appoint my wife, Doris K. Kitner, Executrix of this my Last Will and Testament. In the event that Doris K. Kitner is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint my son, Vance L. Kitner, III, as alternate Executor of this my Last Will and Testament. 5. The Executor or Executrix of this Will shall have the power to distribute my estate in cash or in kind, or partly in either. 6. I direct that no Executor or Executrix acting under this Will shall be required to enter bond in any jurisdiction. 7. I recommend that my Personal Representative retain the law firm of Allied Attorneys of Central Pennsylvania, L.L.C., to probate my estate. IN ITNESS WHEREOF, I have hereunto set my hand this day ~7 of , 2012. ~, ~ ~~ ~~~ ~~~~ ~ `_~ VANCE L. KITNER c'} ~; ~ m ; W © ~-_ ~ ~ -~ _,a rn ~ c-, .. ~~ ~ ~. r ; ~ , ~' Y"t ~ ,~ ~ ~ "Y"~ ~ Page 1 of 4 The preceding instrument consisting of this and three other pages was on the day and date hereof signed, published and declared by VANCE L. KITNER, as and for his Last Will and Testament in the presence of us, who at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. Witne s Witness Page 2 of 4 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA SS COUNT' OF CUMBERLAND I, VANCE L. KITNER, the 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. > '~G--.. ~~ VANCE L. KITNER COMMONWEALTH OF PENNSYLVANIA S.S. COUNTY OF CUMBERLAND On this ~_ day of v~ , 2012, before me personally appeared VANCE L. KITNER, known me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and he acknowledged that he was the declarant who executed the same for the purposes therein contained. IN WITNESS WHEREOF I hereto set my hand and official seal. otary u h1pIA+R~~ SEAS. +n r ~ faS1iC, „~f .f !. ~~ ~ , .~ '.ifs I ~~~~ C(r~ , , _ . ~'.:~'' .r~"...` -~---=-~ ~~" X015 Page 3 of 4 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND . ~ ~ ~~~~ WE, X ~"" C ~S and the witnesses whose names are attached to the foregoing document, being duly qualified according to law, do depose and say that we were present and saw testator sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the Last Will and Testament as witnesses and that to the best of our knowledge the testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. c Sworn or affirmed and subscribed befor//e__me by ~ R and ~Li'Y1 UC'ly this IX/ ~'ll~{,S ~`~ day of , 2012. of u lic/Attorne 3 ,~ ~. `~v~~ ~~: Page 4 of 4