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Home My WebLink About01-24-13PETITION F'O.~R* GRANT OF LETTERS REGISTER OF WILLS OF ~ j ry\, 4~ rlc~ 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(s) the following and respectfully requests j the grant of Letters in the appropriate form: Decedent's Information Name: 7YI+~l~V ~'~/~E'~yy/ t~,/T.t?~t/ a/k/a: , a/k/a: a/k/a: Date of Death: ///G .xo%~ -~ File No• d ~ ~ ~J ` ~'i~ ~~~ (Assigned by Register) Social Security No: .36 ~ ~./ ~G~ Age at death: f ~3 Decedent was domiciled at death in ~us*ra~.eL.4~ County, ~~ (Stare) with his/her last principal residence at ~es~ inc.: - }yJ.4-~,cf i¢ tJF ,5~-/i,P,~,~/,¢~ ~,c1,~J i7e~/ ~~/,~,~,~,v;~ Street address, Post Office and Zip Code City, Township or Borough County Decedent died at '~~o_S' ~- Street address, Post Office and Zip Code City, Township or Borough/ County State Estimate of value of decedent's property at death: Ijdonriciled in Pennsylvania ............................ All personal property $ l'~~ O G Q If not domiciled in Pennsy!vania ........................ Personal property in Pennsylvania $ If not domiciled in Pennsylvania ........................ Personal property in County $ Value ojrea/ estate in Pennsylvania ......................................................... $ TOTAL ESTIMATED VALUE.... $ Real estate in Pennsylvania situated at: vk'Ylt~ • 1~~~1.E /~[~ ~$~i.QiEi~~>.4rt~S%c'u!•~ / ~g/~ ~~..~.r,(~~~,~J (Attach ndditionnl sheets, i(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 L and Codicil(s) thereto dated State relevant circumstances (e.g. renunciation, death ajexecirtor, etc.) ~NO EXCEPTIONS ^ EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (If applicable) c.t.u., d.b.n., d.b.n.c.t.a., pendente life, durunte absentia, durunte tninoritate 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 Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by the Bowing spouse (j~ty) adit#te~(uttuch additional sheets, i/necessary): ~ Q ~ A r'r'i ,~ Name Relationshi A11d-`~ s~ ~-~ .`~ a i.-~;, ~... ~,;.. S ~ , w ; , E~.... ~ .+`' ~~'3 --,~-, . ~t +:: ",a ~ . - ._ , ... t 1A ~ "~'4 <.-~ Except as follows: after the execution of the instrument(s) offered for probate Decedent did not many, was not divorced, was not a party to apending 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. Fo,-~„ aw-nz rev. !0/11/2011 Page I of 2 Oath of Personal Representative CO~[~(O~~.VE.~LTH CF PE~~'S`i LV,~~,'l.~ ) S~. ~'._` OF R ~~.~` . ~. .~ „~ ~~C~{rs<R~ ~aF/~C, f~c.•17iPt I t M e v i_ /S h/iP'TiJ ' C~.t° • ~ isFul 1tT ~~ , ~/4' L/~t-~E E/c' GLEr~ ~~13 ~~ - The Petitioner{s)above-named swear(s) or affirm(s) the statements in the for Petition are tn~e acid correct to the best of the knowledge and belief of Petitioner(s) and that, as Personal Representative(s) of Decedet to Petition r(s) will we nd truly administer the estate according to law. Sworn to or affirmed a d subscribed be~ Date s' met ' day o Date / ~ BYt ~ `~ ~' i{` Date a?y For the Re;dster Date BOND Required:QYES ~NO FEES: Letters ....................... $ ^ • Cif..) (~ )Short Certificate(s)...... (S ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other i ll ........ ~ - a~'a-~~-~ ...... Automation Fee ............... ~~- JCS Fee . .................... G TOTAL ..................... $ ~ ' 1 To the Register of Wills: 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 ~`~~ ~'(U{ _1J ~ ~ ~ ~ i ~ '~~ ~~~ File No: ~ " l~~ ~~ ~ ~,~ a/k/a: ~_ -~-- ~- AND NOW, ~ ~ y v , ~~ in consideration of the fore oing Petitn, satisfactory proof having been presen a before me, IT IS DECREED that Letters ~~~ ~- ~ (;l, _ are hereby granted to ~ " ~ in the a estate and (if applicable) that the instrtunent(s) dated I described in the Petition be adm tted to probate and filed of record as the last Will (and Codicil(s)) of Decedent` ~ t '~ ~ ~ i' ,~- t Register of Wills `~~ ~ ~~~ C~~~=~=~ ~) ~~(~ (,C, Fern. R cv_m .._.. inn ,.,n. ~ _ - _ _ _ _. - `^ .. .• - -.. (iln, Cllr RFC lnl'. ~~;. LOCAL REGISTRAR'S CERTIFICATION OF DEATH VIVARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. $6.~V' C ~ ~ ~ "~ ` ~ - ~' I REC3~~~.`•t ~r ~~,. .~ ~ ~ }r !~, ,~. U ~- ~ ~ . P 1917 9 4 ~ ~ ~ "' `~ Certification Numb ~U~~ERLAP•~? ~~_ rent This is to certify that the information here given is afrrectly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be t;.~Irwarded to the State Vital Records Office for permanent filing. .. -_ ~~ ~ ~ a ~ / s `' ---'~~ r •~1 R~, ctrar Tlarr-~ Tccni=rl COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECDR05 ` CERTIFICATE OF DEATH 1. Decedent's Legal Name (FIrsL Middle. Last SuRlal 2. Ses 3. Social Security Number d. Date of Death (Mp/Day/Yrj (Spell MPj Evelyn Controy Fenale 360 - 03 - 9644 January 16, 2013 Sa. Age-Last Birthday IYrsl 56. Under 1 Year St. UMer 1 D b. Date of Birth (Mn/Day/Year) (Spell Month] 7a. Birthplace (Clh and State or FKelgn Country) Months Days Hours Minutes Carrollttx2, IL 93 June 27 1919 7b. Blrthplue ICaunryj Greer3e Ba. Rlsidlnte (State or Foreign Country) Sb. 0.Kltlence (Street and Humber ~ Irklude Apt No.l 8c. Old Decedent Live in a Tournihip? Penns lvania le Avenue t M 208 w ^yes, de<edmu«ed m _ two. 8a. ResldelKe (CW nry) es ap Shiremaz3stcs~m k be ClanUerland & gt}idenct Izlp cpdtl _ t Y/ rp. ~Nn, dKedem Byte whnln umR: pf 9. Eve in US Armed Forces? 10. Marital Status al Time of Death ^ Married ^ Widowed 11. Surviving Spouse's Name (If wile, give name error to firs[ marriage) Yes ~ Np ^ Unkmwn ~ Divorcetl ^ Never Marred ^Unknow 12. Fathei s Name (First Mddle, fast, Su'tial 13. Mother's Name Pf101 t0 First Marriage (sirs[, Mlddll, Las[) Nicholas Kirbach Mary Hansen Ida. Inlermant's Name ldb. 0.elationship to Decedent ldc. Inlormant's Malling Address (Sheet and Number, Ciry, State, Zip Cadet Janet Holm Qa hter 580 Ial~ (~mline Rice Rrtt~a C;leF2, VA 22596 wPwr II Death Occurred In a Mmpltal: LJ Inpatient I 3 a.Pact Deat ChK on one ~ a ry C1 OKeskntl Hpme h Occurred Somewhere Other Irian Hospital Hospice Faclll t Deat ^ Emergency Room/Outpatient ^ Dead on Arrival ~ YaA E! Nursing Heme/LOry~Term Care Facility Other (Speciryl I 150. FKiliry Name IIF not instltuNen, give street arM number' Sc. [ItY a Town, State, M Zip Code lSd Ceunry of Death Coup Meadows West Mechanicsburg, PA 17050 Clupberland SBa. Method of Dispesi[bn ~ Buda) Q Cremation I 6b. Date el Dlsposltbn ] 6c. Place of Disposition (Name of cemetery, crematory, Pr other place) Removal from State ^ Oonauan other jspecifyl 23 2013. Gate of Heaven Cgnet 16d. loatlon of Dispositlan (City «TOwn, State, aM Zipl 1 )a. Si of Fu Serv l MSee or Person in Charge of Interment 1]h. Lkenu Number Mechanic PA 17055 FD - 014889 l7c Name and Compl to Address of Funeral FKillry Mal zzi Funeral Hone 8 Market aza Way 'csburq, PA 17055 I8. Decedent's Educatbn - ChecN the boa [het best describes the 19. Decedent of Hispanic Origin ~ Check the 2 0. DKetlent's Race ~ Check ONE OR MORE nxs tp indicate what highest dryree or level of School completed at the time el tleath. boa that best deurilses whether the decedent t e dKeden[ considered himself or berulf [o be. h 8M grade or Ills Is Spanhh/Hispanic/Latino. Check the "NO' s MN gy White ^ Korean Q NO diploma, 9th ~ 12M grade boa if decedent is not Spanish/Hlspanic/Latino. ^ Black or Afrkan American ~ Vietnamese 1] Nigh sthOPl graduate or GED competed QNp, not Spanish/Hispanic/Latino ^ American Indian or Alaska Native ^ OMer Asian Some mllge credit but no tlegree ^ Yes, McKltan, Mdlcan American, Chicano ^ Asian Indian ^ Native Hawaiian Assalate dgree (e.g. AA, AS) ^ Yes, Puerto Rkan ^ Chinese ^ Guamanian or Chamorro ^ Bacbebr's Degree le.g. BA, AB. BS) ^ Yes, Cuban ^ Filipino ^ Samoan ^ MasMCS dgrtt (e.g. MA, MS, MEn& MEd, MSW, MBA) ^ Yes, other Spanish/Hispanic/Laura ^ Japanese ^ Other PKilic Islander ^ Doctorate (e.g. PhD, Edo) or Professional degree 19peciNl ^ Other (SpeciN) .. MD DDS DVM LLB 10 21. DecMent's Single RKe Seli-Designation -Check ONLY ONF to indicate what the decedent consbered himself or herself to be 22a. OKedent's Usual Occupation - Indicate type o/work Q(White ^lapaneu ^Samwn done duringmost ofworking life. DO NOT USE RETIRED. Black or African Amercan ^ Korean ^ Other Pacific Islander E]CeClltiVe Secretary Amedcan Indian or Alaska Native ^ Vietnameu ^ Den't Know/Not Sure Q Allan Indian ^ Other Asun ^ Reluud 22b. Kind el Business/Intlustry Q CMneu ^ Native Hawaiian ^ OMer (Specify) -_ SeCretarlal ^flllpiro ^Guamanlan or Chamorro REM523a-tad M115T 8E COMPlETEO 23a. to Pro ante Otatl (Ma Day/Yrj 23b. Signaturepl Pe Pronouncing Death (DnN wben app cable] 23<. leers! Number gY PERSON WHO PRONOVNCES ORj /1 ~ ~[J ~C s ~ ~ ~ ~ ~_ A' Jry CERTIFlES DEATH J KL'(L/ ~ ,W L~ ~ IV ( `a'~•- -.) \ .~s - . 23d. Daft - ed Mo Day r) 2a. T r- s/J1 25 W Medltal Eaaminer or Coronr Contacted? ^ Yes flu CAUSE OF DEATH € Approaimme 26. Part L Enter the chain Of events--dluases, inluries, or complications--that directly cauud the death. DO NOT enter terminal events such as ca•dlac arrest Interval: respiratory wrest or ventdcular fibrillation without hawing t t logy. DO NOT ggBREVIATE. Enter only one cause on a line. Add additional lines if necessary Onset Ip Death e IMMEDIATE UUSF S ` ~ ~ \~ ___- (Final disease er conaition Due to le. as a conseauence-op~- (~ resulting in dead,) S L, J `(/~ ~ J /1.~.\ 1 < > ~ 4 ~ J ~ t S b. - ----- -_ `._.-_-'- SeOU<ntlallY Ibt cendluons, Oue to (or as a consequence oN. d any, leading to the ouu listed on Ilne a. Enter the _. . _ --.-- - UNDERITING GVSE Due [o (or as a consequence ofj (diusu or mlury that inltlated the events resulting d. __._ __ -._ in death) LAST. Dut to (or ai a consequence of) 2ri. Part 11. Enter other }serif ant condltbns contrihu[inK to death but not resulting in the underMng cause given in Part I 2). Was an autopsy perf rmed? ^ Yes I~No 28. Were autopsy Flndirys available to complete the cause o1 death? ^ Yes ^ No 29.1 Fe e 30. Dld iobatco Use Centrlbute to Deaths 31 er of Death pregnant vnMln past year ~ol P robably ^ res ^ ~Nalural [] HomrcWe ^ Pregnant at ume of death _...// ....__ // ^ No ~nknawn Q Accident ^ P<nding Investigation Q Not prgnanL but pregnant wit Nn A2 days of dtatl ~ Sulatle Q Could not be tle[erminetl Q Not pregnant but pregnant d3 tlsys to 1 year before tleath 32. Date of Injury (MO/Day/yr) (51x11 Month) Unknown If pregnant whhin the past year 33. Time of Injury 31. Platt of Infury le.g. home; constructbn site; farm; school) 35. Location of Injury (Sheet and Number, CIN, State, Zip Cotlel 3E. Injury at Work 3]. 11 Transportation Injury, SpeciN: 38. Deuribe How Inlury Occurred Yaa ^ Driver/Operator ~ Pedeftdan No ^ Passenger ~] Other (Specify) 3 Ifler (fMck onN one): $[ertJMng physkian - To the best nE my knowledge, death occurred due to the cauu(s) and manner stated Q Pronouncing 8 C<rtilying Physkun -TO the best of my knowledge, death occurred at the time, date, and place, and due so the cauu(s) and manner stated xls) 0 morn r st [etl u Q Medical EKaminer/Coroner- On s of saaminatipn, and/err Inves[Igatlon, In my opinion, death occurred at the time, date, and place, and due to the ca JJ ~~ 3 ~ ~ ~~ ~ C7 ~ y License Number: V TIHe of certifier. Signa[urc Of certlller' 39b. Name, Address and Zlp Cod<ef Person Completing Cau f ath (Item 2g) 39c. Date Igned (Mp Y/Yr) P 10 ~ I' i3 W. Rgfstnr's DlsWCI Number /l. Regjgtr nature a2. R tr le D to (FAp Dar r) ~ a~ • a 11 W ~ }t ~~/j 63. Amendments H 105-163 OHPpsluan Permit Na. 0819536 _ REV m/2ou LAST WILL AND TESTAMENT OF MARY E. CONTROY ~~ :. ~' ~~ I, MARY E. CONTROY, of the Borough of Shiremanstown, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, in eq~l shams, c ~- ~ rr~ my children, RICHARD P. CONTROY, DONALD J. CONTROY a'81c'~;JANEfI'-A. ~~ a~ - -, HOLM, provided that should any of my children prede a-s .?me~I ' "i ,''E give and bequeath such child's share unto his or her~s~ue der ::. _~, ~a:~ .y stirpes by representation, and if there be a failure="oaf -same: then I give and bequeath such deceased child's share 'to my ,~, ~., surviving children as provided herein. -.E ,__, ~, ,.~> ::~ 'y't SECOND: In addition to all powers grantedhto them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. ~,\~~ ±:~ .,~ ~, ~?~ 1y i ~ ,.,~ G. r~ ~,~e (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights which they may have under the plan, in whatever manner they consider advisable. THIRD: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. F URTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any 2 beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. FIFTH: I nominate and appoint my children, RICHARD P. CONTROY, DONALD J. CONTROY and JANET A. HOLM, Co-Executors of this, my Last Will and Testament. I direct that my Executor or Executrix, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~~" ~ day of •~ r _ --•~-- ~...~-~ a z.~l/1~~~ ( SEAL) MA Y CONTROY ~, ~.r Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address Address ~. v 3 :J !; i ~r LLL i f v ,~, l OATH OF SUBSCRIBING WITNESS(ES) ~,, .~ ,,~ uz<: ~t~~. ... j + ,~ rt r+e i~i''ti~I:v ,~ _,1 i REGISTER OF WILLS t; jJ M g E ~C e ~~~ ~_,~ ?°. ~~ ~: CUMBERLAND COUNTY, PENNSYLVANIA ai-~3~c;~-~~ Estate of MARY EVELYN CONTROY ,Deceased James D. Bogar , (each) a subscribing witness to (Print Name/s) the ~ Will 0 Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she / he /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 Testator /Testatrix in her /his presence and in the presence of each other. (Signature) (Street Address) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this of , Deputy for Register of Wills day Executed out of Register's Office Sworn to or affirmed a~n/d subscribed before me his ~7 ~`~ day of ~ r ~C1 / 3 . `~ ~~ Notary Public _ My Commission Expires: l a ~~~~i~ (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Form RW-03 rev. 10.13.06 (Signat e) One West Main Street (Street Address) Shiremanstown, PA 17011 (City, State, ZipJ MMMONWEAlTH OF PENNcvi v~~A '~bTARlAL SEAL BETH & LENGEL, NOTAR~I PUBLIC SIiIREMANSTOWN BORO, CUMBERLAND COUtII- M~ COMMISSION EXPIRES DECEMBER 12, 2015 OATH OF NON-SUBSCRIBING WITNESS(ES) ~f REGISTER OF WILLS Lu'yY~~~~(~ COUNTY, PENNSYLVANIA Estate of ,~~~y ~ ~'~'~y'`~ <-- ~'`~ ~'~° ~f ,Deceased ~~'~ .4-n/it/,~ C'o,c.l `moo ~ and (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were well- acquainted with ?~~~~! ~c% ~o~~~o with the handwriting and signature of the decedent, and that tr and am,/are familiar signature of 1~~d% ~i~~~y~<-o~!~ 1/ to the foregoing instrument purporting to be the Last Will and Testament/Codicil of i¢~ t ~= c,~rg,~ ~ r,cJ'%Qa is in his/her own proper handwriting. ~7~in ~'~v>-one ~rn.t~ (Signal e 2 I~dir(,~,ci~~ (~Ti y-C (Street Address) l.U GZr m~`~~S 1~t~ ~d` [ ~~ 7y (City, State, Zip) Executed in Register's Office (Signature) _ ~ n t„'• ~ rn c ~ cs (Street Address) ~ ~~ _ r:• •,..., F7 ~ . (City, State, Zip) 6"'- ^;~rr • ~ -..-= ., ,. . 'sue C.;~ ;,.1 ,> ., c::~ ~;::r .,.. ~'~ ~ __.. ~ ~ U";".~ >> Sworn to or affirmed and subscribed before me this n day of~~ , ~-. 1_ ~ ~ eputy for Register of Wills Form RW-04 rev. !0.13.06