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Home My WebLink About03-11-13PETITION FOR PROBATE AND GRANT OF LETTERS Register of Wills of Cumberland County, Pennsylvania Petitioner, named below, who is 18 years of age or older, applies for Letters as specified below, and in support thereof, avers the following and respectfully requests the grant of Letters in the appropriate form:: DECEDENT'S INFORMATION Estate of JO ANN MUSSELMAN Deceased Date of Death: February 13, 2013 File No._~,% ~ ~ G "~ - ~ ~(, `~ Social Security No. Age at Death: 87 Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with her last family or principal residence at 1954 Chestnut Street. Camp Hill Borough. Cumberland County PA 17011 (List street, address, town/city, county, state, zip code) Decedent died at 1854 Chestnut Street, Cama Hill 17011 Cama Hill Borough Cumberland Co PA List street, address, Post Office and zip code city, township or Borough County State, Decedent at death owned property with estimated values as follows (If domiciled in PA) All personal property .....................................................................$ 500,000.00 (If not domiciled in PA) Personal property in Pennsylvania .....................................$ (If not domiciled in PA) Personal property in County ....................................................$ Value of real estate in Pennsylvania ......................................................................................................................$ 179.000.00 Total ......................................................................................................... $ 679.000.00 Real Estate situated as follows: 1954 Chestnut Street. Camp Hill 17011 Camp Hill Borough Cumberland Co.. PA (attache additions/sheets if necessary) Street address, Post Office and Zip Code City, Township or Borough County, State LJ A. Petition for Probate and Grant of Letters Testamentary Petitioner avers he is the Executor named in the Last Will of the Decedent, dated August 2, 2001 State relevant circumstances, e.g. renunciation, death of Executor, etc. Except as follows, After the execution of the instrument offered for probate, Decedent did not marry, was not divorced, and was not a party to a pending divorce proceeding at the time of death wherein grounds for divorce has been established as defined in 23 Pa.C.S.A. § 3323(8) and did not have a child born or adopted and the Decedent was neither the victim of a killing and was never adjudicated an incapacitated person D NO EXCEPTIONS ^ EXCEPTIONS ^ B. Petition for Grant of Letters of Administration (if applicable) enter: c.t.a.; d.b.n.c.t.a.; pendent elite; durante absentia; durante minoritate If Administration, c.t.a. or d.b.n.c.t.a., enter the date of Will in Section A and complete list of heirs Except as follows: Decedent was not a party to a pending divorce proceeding at the time of death wherein grounds for divorce has been established as defined in 23 Pa.C.S.A. § 3323(8) and was neither a vict~l of a killin~`and 1~~6ever adjudicated an incapacitated person ~ c~ ^' rti tst ~ ~ ~ ~ n ^ NO EXCEPTIONS ^ EXCEPTIONS rn ~~-'. c; =~ cn %~+ Petitioner, after a proper search, has ascertained that Decedent left no Will and was sur~rett?b~,{he ~ollowiit~ ~p"ouse (if any) and heirs (attached additional sheets, if necessary) c~ c, ,-., -,,r ° °'~' °~ ~- . i r :::~t r~ ~ T":' Name Relationshi Residence ~- ~. ~~ ~°t OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND RECO~i~"~ fy~Yl ~:~ g~ REGiS~~.=; ~,; r Official Use Only ~'~ 3 ~1Afl 11 ~.; ~ s 6 ~.L~'-'~; rR' ;~; _ . Petitioner's Printed Name Petitioner's Printed Addre _ '• ' ' BRIAN C. MUSSELMAN ` ' ''' '"'-' • ~ ~ +• 1915 LINCOLN STREET CAMP HILL, PA 17011 The Petitioner above-named swears or affirms that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner will well and truly administer the estate according to law. ~ ~ ~ Sworn to ar~d affirmed and subscribed ,~,~._ 3 ~~ l ~ r BR/ANC. MUSSEL MAN Before me this ~_ day of ~ ~ ~ ~ ~ 013. ~~~ r the register BOND Required FEES Letters ........................... { y) Short Certificate(s) { }Renunciation ............. { )Codicil(s) { )Affidavit(s) .................. Bond Commission 9ther ~,~; ., ~, ~z~ ~~r~ Automation JCP Fee ...................... TOTAL......... ^ YES D NO $ ~~ i Y $ ; z-~ $ I ~, $~ $_ ' $ ~,,~;fl $ ~i%C":~~, ~C: To The Register of Wi/ls Please enter my appearance by my signature below: Attorney Sig ture: ~~ Printed Name: EDMUND G. MYERS Supreme Court I.D. No: 20558 Firm Name: Johnson, Duffie, Stewart & Weidner, Address: 301 Market Street, P.O. Box Lemoyne, PA 17043 Phone: 717-761-4540 Fax: 717-761-3015 Email: EGM(cr~jdsw.com DECREE TO THE REGISTER Estate of JO ANN MUSSELMAN ,Deceased. File No. ~>~ ~ ~ ~.~ ' ;~ ~~~~ Social Security No: ate of Death: February 13, 2013 AND NOW, ti~`~C~(C',rl ~ I , 2013, in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters . Testamentary are hereby granted to Brian C. Musselman in the above estate and that the instrument dated Au ust 2, 2001 described in the Petition be admitted to probate and filed of record as the Last Wili of the Decedent. egister of Wills ~ },_ (~~ ~~ 4 ~~~%C~al~ - iC,~rJ C,~~ w~`~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. RECORDED !?~~'!CE CE Fee for this certificate. 56.00 REGIS '~ ' t' TI P ~~,;~ QF ~~;~ ~ S i(~ i, u~ cc(h~r that the lntormatlon here given 1s cOrrectl_y copied ii~om ~)n original Certificate of Death )~~~ ~ilfl ~~ ~t f ~ ,~ „~ dnly tiled Frith n(e a~ Local Registrar. The original ' ilfl (f ! ~ c<~r~ificate ~~~ill }~r_ ~~nrwarded to the State Vita] Krccn~d~ Offi~i)r nrrnu(nent tiling. CLERK 0~. ~~~~ 93~S~~~ORPHANS'CC~,'R~ ____ // CUMBER! er'an r: ccn ~ c ~nd~ Certification Number ~ ~ a. rr- - - --' ... •• - ,. , i r~ L_LJL~u j~cr:l~u al a e SSUe(. Type/Print In COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS Permanent I ? i)' g 1. Decedent's Legal Name (First, Middle, Last, Suffix) v • ~ ^ State Flle Number: 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Vr) (Spell Mo) Jo Ann Musselman emale 1 8 Sa. Age-Last Birthtlay (Vrs) Sb. Under 1 Year Sc. Under 1 Da 6. Date of Binh (MO/Day/Vea r) (Spell Month) 7a. Birthplace (City and State or Foreign Country) 87 Months Days Hours Minutes Harrisbur PA 1VOV 2 1 f 1 9 2 rj 7b. Birthplace (County) 8a. Residence (State or Foreign Country) Sb. Residence (Street antl Number -Include Apt No.) 8c. Ditl Decedent Live In a Township? Penns lvania 1 854 Cl-lestnut St. ~ves,detedenulvedln r~ ~ u,,.; i i gd. Residen (cpgnty) ^t T'+ twp Cum€ier 1 and 8e. Residence (Zip Cade) '~ 7 Q '~ ~ Q No, Decedent lived within limits of 9. Ever In s rmed Forces? 10. Marital Status at Time of Death ~ Married Widowed 11. SurviVin 5 city/born. Q Ves No Q Unknown Q Divorced Q Never Married ~ Un n g Pouse's Name (lf wife, give Warne prior to first marriage) 12. Father's Name (First, Middle, Last, Suffix) w13. Mother's Name Prior to First Marriage (First, Middle, Last) Cecil C_ Crull Esther Gemmill 14a. Informant's Name 146. Relationship [p Decedent 14c. Informant's Mailing Adtlress (Street and Number, City, State, Zip Code) Brian C_ Musselman '19'15 Lincoln S ' ¢ ~~ .. ....... .............. 16a. P ace o Deat C ec If Death Occurred In a Hos ital: ......................................................... on y one ............... .......-... P 1~ Inpatient If ~~ . ~ p...... ; Death Occurred Somewhere Other Than a Hos plta l: 1~ Hos ice Facilit y.~• ~"""""""" ~ Emergency Room/OUtpaileht Dead on Arrival ~ y wry Decedent's Home ~ Q Nursing Home/Long-Term Care Facility Other (Specify) 36b. Facility Name (If not Institution, give street and number; .15c Cit . y pr Town, State, nd Zip Code i5d. County of Death 1 954 CYlestnut St C m . am Hill PA l 70'1 1 Cumbe 16a. Method of Disposition Burial ~ Cremati r lan r ~ on 166. Date of Disposition 16c. Place of Disposition (Name of cemetery, ory, her place) r m p Rem°ym frpm state p Dpnatipn Feb . 1 8, 2 0 1 ocher (speTlry) S l a t e H i 11 C e m SX+ 16d. Location of Disposition (City or Town, State, antl Zip) 1t'dJSianature of Fu ne~s~ytte Licensee or Rr n in Charge of Inter 12b. License Number fGys ~ ~ jj 2 -- ~,(j!/Ll 9e ~ if~.6- ~ ^. Lower A11en ~ Tw PA17011 FD-013163-L llc. Name and Complete Atltlresz of Funeral Facility M ~ usselman FH&CS Snc_ 324 Hummel Ave Lemo ne PA 17 ' . 4 1g. Decedent's Education -Check the box that bast describes the 19. Decedent of Hispanic Origin -Check the ' 20. Decedent s Race -Cheek ONE OR MORE races to Indicate what highest degree or level of school completed at <he time of death, box that best describes wheth th er e decedent the decedent considered himself or herself to be. 8th grade or less is S anish/Hi " " p spanic/Latino. Check the NO White 0 Korean ~ No diploma, 9th - 12th grade b If d o ecedent is not Spanish/Hispanic/Latino. ~ Black or African American Q Vietnamese Q High school graduate or GED completed N o, not Spanish/Hispanic/Latino ~ American Indian or Alaska Native ~ Other Asian Q Soma college credit, but no tlegree ~ Y es, Mexican, Mexican American, Chicano ~ Asian Indian 0 Native Hawaiian Q Associate degree (e g. AA, A6) Q V P c es, uerto Rican Chinese ~ Bachelor's degree ( .g. BA, AB, BS) ~ yes ~ Guamanian or Chamorro Cuban O , FIII Inp Master's degree (e.g. MA, M5, MEng, MEd, M6W, MgA) Q yes, other 5 ~ P Q Samoan /7 x / Pantsh/Hispanic/Latino ~ Japanese Q Oth ~DOCtorate ( P PhD if d er e.g. , E ac D ic Islander or Professional degree /C /Y (Specify) 0 ether (Sped . MD DDS DVM LLB JD fY)- 21~. Df cedent's Single Race Self-Designation -Check ONLY ONE to Indicate what the decedent considered himself or herself to b 2 ' e. 2a. Decede Wt s Usual Occupation -Indicate ~} White Q Japanese Samoan tYPe of work ~ done Burin ~ Black or African American ~ Kprean g most of working life. DO NOT VSE RETIRED. Other Pacific Islander Q American Indian or Alaska Native ~ Vietnamese ~ pon'Y Know/Not Sure registered our s e ~ Asian Indian ~ Other Asian ~ Refusetl 22b. Kind of Business/Industry Q Chinese Q Native Hawaiian 0 Other (SpeciTy) Q FRipino Q Guamanian or Chamorro ho s p i t a 1 ITEMS 23a - 23d MUST BE COMPLETED 23a. Dale Pronounced Dead (MO Day Vr) 236. Signature of Person Pronouncing Death (Onl PRONOUNCES OR whe li bl y n app ca e) 23c. License Number ~, A ~, ~~ ~ ,// CERTIFIES DEATH 23d. Date Signed (MO/Da /Vr) ~ ~~ G ~` / ~ ~ ~ y 24. Time of Death C. fb'~2-^^ ^•-~ ' " ~ '~ '~i(1'H-/ 2 a / . Lf7j' 26. Was Medical Examiner or Coroner ContactedT Q ~ No vez CAUSE OF DEATH 26. Pert 1. Enter the ch I f t --diseases, injuries, or complications--that direct) Approximate y caused the tleath DO NOT ent t . er respiratp r v erminal events .such as cardiac arrest Interval: ry arrest, o entrlcular fibrillation without showing the etiology. DO NOT qBB REVIATE Enter onl . y one cause on a line. Add additional lines if necessary Onset to Death IMMEDIATE CAUSE ------------- 1 . . r ~ ~~, ~ ~ „1„~ _ ~ -- ~ ~ ~v 1~ a. (Final disea se or contlitlon Due to (or as a consequence of): resulting In tleath) ' 7 R~ b. 7~ y~~y ,/ R•7./ ~ '><~'t~ si4.... .~ J ~ ~ - - ._ - /ice -a.r-i-- .Ci Sequenflally list conditions, ~~ Due to (or sequence of): if any, leading to the cause as a con / listed on Ilne a. Enter the UNDERLYING CAUSE Due to (or sequence of): (disease or Inj ry that as a con F 4 Initiated the events resulting d. (n tleath) LAST C_5 . Due to (or as a con sequence of): S 26. Part 11. Enter other slgniflca nt contliti t Ib TI t 1 th but not resulting In the underlyin cause i i g g ven n Part I 22. Was a autopsy performed? ~ Ves ~~ No 28. Were autopsy findings available to i co ~ p ece the ea use of tleath? 29. If Female: o Ves E o 30. Ditl Tobacco Use Contr(bute to Death"T ® Not pregnant within past year 31. Manner of Death 0 Pregnant at time of death (] Yes Q Probably '~ Natural Homicide 0 °~ Q Not pregnant, but pregnant within 42 tla ~NO ~ Unknown Accident Ys of death ~ Q Pending Investi ation ~- g ~ Not pregnant, but pregnant 43 days to 1 year before death 32 ~ Suir_ide 0 Could no< be determinetl Date of In M . jury ( O/Day/Vr) (Spell Month ~ Unknown If pregnant within the past year ) 33. Time of Injury 34. Place of Injury (e.g. home; consiructlon site; farm; school) 3 5. Location of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: 0 Yes ~ Driver/Operator ~ Pedestrian ~ No ~ Passenger ~ Other (Specify) 39a. Certifier (Check only one): ~ Certifying physician - To the best of my knowledge, death occu rretl due to the cause(s) a d n manner sta[etl Pronouncing 6 Certifying physician - To the best of my knowledge, death occurred at the time date and la tl M di , , p ce, an e due fo the cause(s) and manner s ated cal Examiner/Coroner - On She basis of exa {nation, antl/or investigation, In my opinion death d , occurre at the time, date, and place, and due to the c se(s) and manner stated Signature Of certif(er: -st h 3 hc__ / Title of certiFler~ ~ ~ License Npmber~ Z f '~ Z/j .~.. 9b./(y/~me, Address and Zip Code sof Pers n Compl Slog Cause of D ih (It 26) / 7/6 !~ Q {yJ d ~'j QL Y.. _ ~j r ~ n ~O d ~ ~3 ` ~~- ~ 39c. Date Signed (MO/Day/Yr) ~ ` 4 Q C ~ p 0. Registrar's District Number G4 / ~~ r ~ / ~ !- ~ / 41. Registrar's 51 _~r 42. Registrar File Dale (MO/Day r) ` // ~/C/ 4 3. Amend mcnts O~ ~ ` G _ a O / rrEM # 8a ~~s~ ~~~s~.r/,~~ s % Q ~ SHOULD READ Disposition Permit No. ~ X ~ ~'~~l H105-143 REV O~/2011 005104-00002/07.24.01 /EGM/KLT/130321.3 ~.~~t ~iYY ~~b ~e~t~mcent OF JO ANN MUSSELMAN I, JO ANN MUSSELMAN, of the Borough of Camp Hill, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I =; ~ n ~ ~~ m I direct the payment of all my legal debts, and the expenses of my 1 i~ness a1~ furr~ r~ _~ n from my Estate as soon after my death as conveniently maybe done. ~ `_' F m ~ r r:; v7 ~~ ~ r . ;;` C, ~ ARTICLE II ` _~ ~ '-~ ~__ N Cry Q ~~ ~ I give and bequeath my motor vehicles, household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, unto those of my children, BRIAN C. MUSSELMAN, DANE C. MUSSELMAN, and LESLEY JO VEREEN, who survive me, to be divided among them by my Executor with due regard for their personal preferences in as nearly equal shares as practical. ARTICLE III I give and bequeath the sum of ONE HUNDRED THIRTY FIVE THOUSAND ($135,000.00) DOLLARS unto my daughter, LESLEY JO VEREEN, provided that should she predecease me, I give and bequeath the same unto her then-living issue per stirpes. 005104-OOOlJ2/07.24.~ 1 /EGM/KLT/ 130321.3 ARTICLE IV I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever nature and wheresoever situate unto my children, BRIAN C. MUSSELMAN, DANE C. MUSSLEMAN, and LESLEY JO VEREEN, in equal shares, the then-living issue of any of said beneficiaries who predeceases me to receive the share of the deceased beneficiary per stirpes. ARTICLE V In the event that any beneficiary of my Will shall not have reached the age of twenty five (25) years at the time of my death, I give, devise and bequeath such beneficiary's share unto ALLFIRST TRUST COMPANY OF PENNSYLVANIA, NA, and in separate TRUST to hold, manage, invest and reinvest the share(s) so received, and the accumulation of income thereon, and to use and apply the income and principal, or so much thereof as, in Trustee's discretion, may be necessary or appropriate for such beneficiary's support and education (including college education, both graduate and undergraduate, and vocational training) without regard to his or her ability to provide for such support or education or to make payment for these purposes without further responsibility, to such beneficiary or to any person taking care of such beneficiary. After the beneficiary shall attain the age of twenty one (21) years the Trustee shall pay and distribute to him or to her the net income of such Trust periodically, but not less frequently than quarterly. When such beneficiary shall attain the age of twenty five (25) years, Trustee shall distribute the then remaining principal and any income accumulated thereon on to such beneficiary absolutely, and the Trust as to that beneficiary shall terminate. In the event any beneficiary dies before receiving his or her final distribution hereunder, the Trust as to that beneficiary shall terminate and the balance of principal and any net undistributed income shall be paid over to such beneficiary's personal representative. 2 005104-00002/07.24.01 /EGM/KLT/ 1303 21.3 ARTICLE VI During the time any portion of my Estate remains in Trust, the same shall not be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof. The Trustee shall pay over income and principal as hereinbefore determined to the parties designated, as their interest may appear, without regard to any attempted anticipation, pledge or assignment by any beneficiary, and without regard to any claims thereto or attempted levy, attachment, seizure or other process, shall be authorized by law or specific order of any Court having jurisdiction, Trustee shall not be liable to any beneficiary for violation hereof by reason of the same. ARTICLE VII If at any time during the continuance of any Trust created hereunder, the Trustee in its sole and absolute discretion determines that the size of any individual Trust account has become so small as to be impractical to continue to hold in Trust and uneconomical to continue to administer as a Trust, then in such circumstances, the Trustee may without further authorization distribute the balance of the principal and income in such Trust account to the beneficiary then- entitled to the income therefrom, and upon such distribution the Trustee shall be released from further obligation with respect to that account and shall not be subject to any claim from any person who may have had a future interest in such Trust account had it been continued in Trust. ARTICLE VIII I name, constitute and appoint my son, BRIAN C. MUSSLEMAN, Executor of this my Last Will and Testament. Should my son, BRIAN C. MUSSELMAN, fail to qualify or cease to so act, I name, constitute and appoint my daughter, LESLEY JO VEREEN, Alternate Executrix 3 005104-OOG02/07.24.lJ 1 /EGM/KLT/ 130321.3 to complete the administration of my estate. I direct that neither shall be required to post bond for the faithful administration of the duties required in any jurisdiction. ARTICLE IX In addition to the powers granted by law, my Executor(s) and Trustee shall have the following discretionary powers, applicable to principal and income, which shall be exercisable without leave of court and shall continue until distribution is actually made: A. To accept and retain any or all property, including stock or other securities of the Trustee or of a holding company controlling the Trustee; B. To buy investments at a premium or discount; C. To give proxies, both ministerial and discretionary; D. To compromise claims; E. To join in any merger, consolidation, reorganization, voting trust plan, or other concerted action of security holders, and to delegate discretionary duties with respect thereto; F. To sell, to exchange, to improve, or to lease for any period of time, any real or personal property; and to give options for sales, exchanges, or leases; G. To allocate any property received or charge incurred to principal or income or partly to each, without being obliged to apply the usual rules of trust accounting. 4 005104-00602/07.24,01 /EGM/KLT/ 130321.3 H. To distribute in cash or in kind or partly in each. ARTICLE X I direct that all estate, inheritance, legacy, succession or transfer taxes (including any interest and penalties thereon) imposed by the laws of any state or the federal government now or hereafter enforced with respect to all property taxable under such laws by reason of my death, whether such taxes be payable by my estate or by any recipient of such property, shall be paid by my Personal Representative out of my residuary Estate as part of the expense of administration thereof, without apportionment and with no right to reimbursement from any recipient of any such property. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~ day of , 2001. ~~~L ~ ' -~,~-SEAL) J ANN MUSSE ,MAN 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, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. `~ _..~ ,I 5 005104-00002/07.24 -01 /EGM/KLT/ 130321.3 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SS We, JO ANN MUSSELMAN, ~ _ -~.c1 and '~~~ ~ ,the Testatrix and the witnesses, resp ctively, whose ,, names are signed to the attached or 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 she had signed willingly and that she 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 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. ~ ~~ ~~y~ JO ANN SSELMAN t ~,~~'~ Witness '~' ~ ~c-a~-~ Wi iess Subscribed, sworn to a11d acknowledged before me by JO ANN MUSSLEMAN, Testatrix, and subscribed and sworn to before me by ~ ~ , -~ ~ and 1~~--- ~,r.. ~' ~.~.r~~ ,witnesses, this ~ a aday of , 2001. Notary Public 6 NOTARIAL SEAL DIANNE LENIG, Notary Public Lemoyne Borough Cumberland Co. My Commission Expires Dec. 21, 2001