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Home My WebLink About01-09-13PETITION 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: TREVA J. BARRICK a/k/a: a/k/a: a/k/a: Date of Death: SEPTEMBER 9, 2012 File No: ~ ~ - ~ L I _~ -- Q(1 z (Assigned by Register) Social Security No: Age at death: 85 Decedent was domiciled at death in CUMBERLAND County, PENNSYLVANIA (Stare) with his/her last principal residence at 8 CONIFER ROAD. NEWVILLE 17241 LOWER MIFFLIN TOWNSHIP CUMBERLAND Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 8 CONIFER ROAD. NEWVILLE 17241 LOWER MIFFLIN TOWNSHIP CUMBERLAND 1'A 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 Pennsylvania ........................Personal property in Pennsylvania If not domiciled in Pennsylvania ........................Personal property in County Value of real estate in Pennsylvania ......................................................... TOTAL ESTIMATED VALUE... . Real estate in Pennsylvania situated at: (Attach additional sheets, if necessary.) $ 4,500:00 $ 4.500.00 Street address, Post Office and Zip Code City, Township or Borough ® 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 APRIL 6, 2011 thereto dated County and Codicil(s) State relevant circumstances (eg. 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(8), 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 O EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c.t.a., d.b.n., d.b.n.c.t.a., pendente life, durante absentia, durante minoritate If Administration, c.t.a. or db.n.c.za., 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 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 Relationshi Address n ~_, C 4.; ~ ~ C1O ~-- ta7 1p =~ C? rn ~ •--t ~..: t m ~ m ~ ~ - ca :a - ~ ~ ~; '~ c~ ~w> -r , ~~ ~~ Form RW-02 rev. 10/11/2011 ~ ~ ~ _ ,, ~~ tv - ;= -v ~ ~~~ ~- __~rn a ~ Page 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND Official Use Only YC ~~t~a~a ~'in'r-t~"' ~~ Petitioner(s) Printed Name Petitio Prj A ess , ALBERT G. BARRICK 1214 CENTER ROAD NEWVILLE PA 17241 BRENDA K. MEALS 1298 CENTER ROAD, NEWVILLE, P ~ ~ ~` ~ ~ `~ ;, . . ., 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) of the Decedent, the Petitioner(s) will well and truly administer the estate accordin o la . Sworn to affirmed a d subscribed before Date ~C ~ ~ t met ' ~ day of; I Date ~O 3. By: ~' Date For the Register Date BOND Required: Q YES Q NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters ...................... $ 30.00 ( 2) Short Certificate(s)...... 10.00 ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ........ WILL ........ 15.00 INH TAX RETURN ........ 15.00 INVENTORY ........ 15.00 Automation Fee ............... 5.00 JCS Fee . .................... 23.50 TOTAL ..................... $ 113.50 Attorney P ' ted Name: MARCUS A. McKNIG ,III Supreme ID Number: 25476 Firm Name: IRWIN & McKNIGHT, P.C. Address: 60 W .ST POMFRF.T STREET C:ART.TRT.F., PA 17013 Phone: (717)249-2353 Fax: j7171249-6354 Email: DECREE OF THE REGISTER Estate of TREVA J. BARRICK File No: ~ I - ~ (~ I, ~ - C C~ a/k/a: AND NOW, ~ ' th 2y ~~, in consideration of the foregoing Petition, satisfactory proof having bee sented before me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to ALBERT G. BARRICK AND BRENDA K. MEALS in the above estate and (if applicable) that the instrttment(s) dated APRIL 6, 2011 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. v Register of Wills , ; ,, Form RW-01 rev. ioi~li2oi~ ~ n'~~ ~~~ ~ Page 2 of 2 -~ _ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $~~+~+~ ~ ~ `~ ~ ~ ` ~ ~ `~ ~ This is to certify that the information here given is z:~,E ~ ~ ~ ! ~ - ~ ~~ ~ i• +r. ~'- .I 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 '~~ 13 '~ ' Records Office for permanent filing. P 18 6 2 8121~~-ELK ° ~ ~Sl~~~~~,.~,~, r~ Certification Number ~ S! ~ ~ ~ ~~ S~ ~ ~~2 D 12 ~~ C1~MBERLANC CO., ~~ Local Registrar Date Issued Type/Print In COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF HEALTH .VITAL RECORDS Permanent _. f COT~G~f"ATC A~ e~rw~u ~I ~_ - State Flle Number: 1. Decedent's Legal Name (Fitz[, Middle, Last, Suffix) 2. Sex 3. SOCIaI Security Number 4. Data of Death (MO/Day r) (Spell Mo) Treva J_ Barriclc emal 200-22-5004 eptember 9, 2012 6a. Ag<-Lest Birthday (Yrs) 56. Under 1 Year SG Under 1 Da 6. Date of Birth (MO/Day Year) (Spell Month) 7a. Birthplace (~ Ity and Sbte Foreign Cou Mgnths Days Hours Minutes C 1 1 >~ `l"~i ~~ ar 1 s e, a nn s y a n i a e p t embe r 8, 1 9 2 7 7b. Birthplace (county) um e r a n 8a. Residence (State or Foreign Country) - 8b. Residence (Street and Number -Include Apt No.) gc. Dld Decedent Llye In a Township? 8 Conifer Road H]Ye: decedenuw<din T []wPr Mi ffl i , . „ Bd. Residence (COUn ) twp. Cumber 1 a nd 8e. Residence (21p Cade) Q No, decadent INed wlthln limits of city/bor 9. Ever In US Armed Fortes? 10. Marital Status at Tlme of Death Q Marrlad Wldowe Il. Surviving Spouse's Name (If wife, give name prior to first marriage) Q Yes ~ Na Q Unknown Q Divorced Q Never Marrlad Q Unknow 12. Father's Name (Fl rst, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Mldtlle, Last) M ers Catherine Lebo 14a. Informant's Nama 14b. Relationship to Decedent 14c. Informant's Malling Address (Street and Number, CI Sbte, 2i Code Alb t B i ~ ~ X g - er arr c7c Son 1214 Center Rd. Newvil e, l A 17241 r. . -F aka ............... ryency ........./ .....Pa ..........-. ............-...-.......-................,......,- l..ac ace-o mat... c _ e on y one .... .... ... -.......... .-. ... ......-. _ _ _ _ __ If Death Occurred In a Hos Ital: In """ "" '• ••- --• ••• - - ........... . p patient ~ :If Death Occurred Somewhere Other Than a Hospital: ~•HOSpIc< Facility `}~]~Qeeedent's Homes ~ ~ • Ema Room Out [lent Dead on Arrlyal _ Nursln Home/Long-Term Care Fac11I Other (Specfy) 156 Facility Nama (If not Instltut{ W . on, g e street and number; lSC. City or Town, State, and ZIp Code lSd. County of Death ~ d Newville PA 17241 Cumberland 16a. Method of Dlsposltlon ~ Burial Q Cremation S6b. Darc of Dlsposltlon lbs. Place of Dlsposltlon (Name of cemetery, crematory, or other plate) p Remoyalfromstae e Q Dpnatlnn Westminster Cemetery Other (Spec) ) 9/ 1 4/ 2 0 1 2 16d. Loutlon of Dlsposltlon (City or Town, State, and Zlpj 17e. Slgnatyj-,a of Funeral rvlce Licensee or Parson In Charge of Interment - 176. Ucense Number Carlisle, PA 17013 ~ FD 13895 L 17c. Nama and COmple[e Address of Funeral Facility E er Funeral Home Inc 15 Big Spring A e. Newville, PA 17241 ~1 1- 1B. Decedent's Education -Check the box thae b.st descnb<s the 19. Decedent of Hlspanlc Orlgfn -Check [he z0. Decedent's Raca -Check ONE OR MORE races to Indicate what highest degree or level of school completed at the Hme of death box th t b rt d b . a e escri es whether the decedem the decedent considered himself or herself to be. ® 8th grade or less i S i h ^ pan s s /Hlspanlc/LaLlno. Check the NO" White 0 Korean Q No diploma, 9th - 12th grade box If decedent Is not Spanish/Mlspanic/Latlno. Q Black or African American Vietna Q mese Q Hlgh school graduate or GED complaLed NO, not 5 Ish Hls pan / panic/Latino ~ American Indian or Alaska Natlye Q Other Asian Q Some collage credit but no degree , Q Yes, Mexlca n, Mexican American, Chlca no Q Asian Indian Q Nat1w Hawaiian ~ Associate degree (e.g. AA, ASj Q Yes Puerto Rican , Q Chlnase Guamanian Or Chamorro Q Bachelor's degree (e.g. BA, AB, BS) Q Yes, Cuban Q Filipino Q Samoan Q Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hlspanlc/Latino Q Japanese Q Oth P lFl l er ac c Is ander Q Doctorate (e.g. PhD, Ed D) or Professional degree (Specify) Q Other (specify) . MD DDS DVM LLB JD 21. Decedent's single Race Self-DesignaHOn -Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22a. Decedent's Usual Occupation -Indicate Type of work White 0 Ja anese p Q Samoan done during most of working Ilfe. DO NOT USE RETIRED. Q Black or Afncan American Q Korean Q Other Paclflc Islander Q American Indian or Alaska Natlye QVietnameze QDon'T Know/NOL SUre COOSC Q Azlan Indian Q Other Asian Q Refused Q Chinese Q Natlye Hawaiian Q Other (Specify) 226. Kind of Business/Industry Q FIIIPino Q Guamanian or Chamorro Nursing Home ITEMS 3e - 3 U T B COMPLETED 23a. ate PronouncedQDea Mo Day r 23 Signature o Parson Pronouncing Death (Only w en appllcab eJ 23c. License Num er BY PERSON WMO PRONOUNCES OR S~PtCMbe~ (, a o /a CERTIFIES OEATN 23d. Date Signed (Mo/Day/Yr) 24. Tlma of Death Q 3~~ PM 25. Was Medical Examiner or Coroner Contacted? Q Yas No CAUSE OF DEATH Apprgximate 26. Part 1. Enter the chain of events--diseases, Injuries, or compllcatlons--that dlrcttly caused the death. DO NOT enter terminal events such as cardia ` c arrest Interval: respiratory arrest, or yen[rlcular fibrlllatlpn without showing The etiology. DO NOT ABBREVIATE. Enter only one Cause on a line. Add additional Ilnes If necessary { Onset to Death IMMEDIATE CAUSE - > GIYS TKlL G/4-L(S~-~_ (~f?~LT/{s (Final disease o dl l r con t on Due to (or as a consequence of): - resulting fn death) b. Sequentially IIST conditions, Due to (or as a consequence of): If any, leading to the cause listed on Ilne a. Enter the ,~ UNDERLYING CAUSE Oue to (or as a consequence of): (disease or lnjurythat Initiated the events resulting d. In death) LAST. Due to (or consequence af): f as a ' 26. Part 11. Enter other Ignlfl t condltlon t Ib Hn t d h but not resulting In the underlying cause given In Part I ~ 27. Was an autopsy performed? Q Yes Q No 2B. Were autopsy findings syelleble $ to complete the cause of death? ~i 29. If Female: 30 d Q Yas No . DI Tobacco Use Contribute to Death? 31. Manner of Death Not pregnant wlthln past year Q Ye9 Q Probabl ~` y ~ Natural Q Homicide Q Pregnant at Ylme of death ~r Na. Q Unknown Accident N Q . •= Q Pendln Inyestl Klon ot pregnant, but pregnant wlthln a2 days of death Q B B Q Not pregnant, Gut pregnant 43 days to 1 year before death 32. Data of In u Q Sulclde Q Could not be determined 1 ry (MO/Day/Yr) (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. Location of Injury (Street and Nu mbar, Clty, State, ZIp Cod<) 36. Injury at Work 37. If TransportaTlon Injury, Specify: 3B. Describe How Injury Occurred: Q Ves Q Drlyer/Operator Q Pedestrian Q No Q Passenger Q Other (Specify) 39a. C<Klfler (Check only one): ~CertlP in h i i T h y g p ys c an - o t e best of my knowledge, death occurred due to the cause(s) and manner stated Q Pronouncing ffi CertHying physician - To the best of my knowledge, death occurred at the time, dote, and place, and due to the cause(s) and manner seaNd Q Medical Examiner/C - O h b n t e as of examinaTlon, and/or Inv<stlgatlon, In my opl oleo, dea~t/h net / / ~_~ _ occurred at the time, dote, and place, and due To the ~a ~ use(s) a nd m ann er stated A , Signature of certlFler 7 ~ p • ` ~ / , Tltla of ce Rlfl<r: /~r~ License Number~fJa "Z L O /~a- 39b. Nama, Address and 21p Code er n Completing Cause of Daeth (Item 26) 39c. Date Signed (Mo/Day r) /=a4/2-A W4e'a~ r+ J c3 S>S Wt7TZTbza+AO z~C.A SO t (~ / K F ~ I /Q./ Af G S ~ / y4 ! 7c~ as ~ Q 9~I0 ` ~O/~ 40. Registrar's Dlstr et Num er 41 Rs lstrar s l . g ure 42. Registrar FI a eta Mo Day 43. Amendments Dlsposltlon Permit No. L J f~ q ~ a,a,~ REV 07/ Oll ~•~ LAST WILL AND TESTAMENT ~'- ~ ~ ~ ~~ ~ of ~ ~ ' ' ~ " ~ ., - ~`~' ~~- a TREVA J. BARRICK ~ ~ ~"c.~c ~ . - , ~~~ ~ ~ c.~: ~ a ' ~ ~ ~ I, ~, J. BARRICK, of Lower Mifflin Township, Cumberland County Pennsylvania ~ r,~n % , , ~~m ,~decl~e this ~ l~ my Last Will and Testament and revoke any Will or Codicil previously made by ~' ~ U me. _. ITEM I: I direct that all my just debts (except as may be barred by a Statute of Limitations) and my funeral expenses (including my gravemazker and expenses of my last illness) shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate. ITEM II: I am presently not married and I have five children: ALBERT G. BARRICK, DAVID BARRICK, STANLEY BARRICK, BRENDA K. MEALS, and JOANNE B. BURKHOLDER. I make this will in this context. ITEM III: I bequeath those articles of my household furniture and furnishings and those articles of my personal effects and personal property as I have or may set forth in a sepazate memorandum (which is or will be signed by me, dated and make specific reference to this Will and memorandum, which I shall place with my Will or deposit with my attorney), to the persons therein designated. ITEM IV: I give and bequeath a sum equal to ten (10%) percent of my estate to my church, the Newville Assemblies of God Church, 403 Oak Flat Road, Newville, Pennsylvania, for general church purposes as shall be determined by the governing body of the said Church. ITEM V: I devise and bequeath all the residue of my estate of every nature and wherever ~~~ situate in equal shares to such of my children, ALBERT G. BARRICK, DAVID BARRICK, STANLEY BARRICK, BRENDA K. MEALS, and JOANNE B. BURKHOLDER, as aze living on the thirty-first (31st) day following my death. Provided however that if at the time of my death I have not been repaid by my daughter, JOANNE B. BURKHOLDER, for sums of money that I have given to her or advanced for her or incurred credit card debt for her benefit, the total of such sums shall be treated as an advancement of JOANNE'S share of any residuary estate and deducted from her distributive share thereof. ITEM VI: Should any of my children, ALBERT G. BARRICK, DAVID BARRICK, STANLEY BARRICK, BRENDA K. MEALS, and JOANNE B. BURKHOLDER, predecease me or die on or before the thirtieth day following my death but leaving descendants who so survive me, such descendants shall receive, per stirpes, the share that such predeceased child would have received had he or she so survived me. ITEM VII: If any property passes outright (either under this Will or otherwise) to a minor (which shall be defined as anyone under twenty-one (21) years of age) and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, I decline to appoint a guazdian but instead authorize my Executor to distribute such property to a Custodian selected by my Executor (and my Executor may act as such Custodian) as Custodian for the minor under the Pennsylvania Uniform Transfers to Minors Act. Provided, however, that this appointment shall not supersede the right of any fiduciary to distribute a shaze where possible to the minor or to another for the minor's benefit. ITEM VIII: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as ~ J ,~ 2 part of the expenses of the administration of my estate. ITEM IX: I appoint my son, ALBERT G. BARRICK, and my daughter, BRENDA K. MEALS, Co-Executors of this my Last Will. ITEM X: I direct that my Executors, custodians, or their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM XI: The interests of the beneficiaries hereunder shall not be subject to anticipation or to voluntary or involuntary alienation. IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on four (4) sheets of paper, dated this ~ day of , 2011. (SEAL) TREVA . BARRIC The preceding instrument, consisting of this and three (3) other typewritten pages, each identified by the signature or initials of the Testatrix, was on the day and date thereof signed, published and declared by the Testatrix therein named, as and for her Last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other have subscribed our names as witnesses hereto. r G' residing at S~ J ~ residing at Uv~s ~ v n ~~ 3 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND . ss. I, TREVA J. BARRICK, the Testatrix 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 that I signed it willingly and as my free and voluntary act for the purposes therein expressed. ~ ~~~ ~ ,~j~~G~ (SEAL) TREVA J. B CK, TESTATRIX Sworn to or affirmed and acknowledged before me by TREVA J. BARRICK, the Testatrix, this ~ day of ~!~ _ , 2011. Notary Public (J v COMMONWEALTH OF PENNSYLVAI~TIA COUNTY OF CUMBERLAND . ss. We, i~1W/1 /~~1 ~ ~l,C! l/ ~' and `~rt,Gt /yI ~/oa~/~7 ~ ,the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her Last Will; that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Will as a witness; and that to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Sworn to or med d s cribed to before me by ~Q~Ji% ~ • and m ~Y _, witnesses, this day of , 2011. Notary Public COMMONWEALTH OF PENNSYLVANIA Notarial Sesl Myela M. Schaeffer, Notary PubBe Shippensburg Bono, Cumberland County h9y Commission Expires May 15, 2011 Member, Pennsylvania Assodation of Notaries 4 C COMMONWEALTH OF PENNSYLVANIA Notarial Seal Angela M. Schaeffer ryp~ry Public lPPensburq Boro, Cumberland County Commission F-xpires May 15, 2011 MM1`l6a~h, Pennsylvania Assadatien of Notaries