HomeMy WebLinkAbout03-13-13
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 requests the grant of Letters in the appropriate form:
Melissa M. McCord
Decedent's Information q
Name: Gertrude R. O'Toole File No: 21-13 - ap,/s-
a/k/a: (Assigned by Register)
a/k/a:
a/k/a: Social Security No: 197-24-0667
Date of Death: 02/16/2013 Age at Death: 101
Decedent was domiciled at death in Cumberland County, PA (State) with his/her last
principal residence at 20 North 12th Street, Lemoyne 17043 Lemoyne Cumberland
Street address, Post Office and Zip Code City, Township or Borough County
Decedent died at 20 North 12th Street, Lemoyne 17043 Lemoyne 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 $ 250,000.00
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 $ 250,000.00
Real estate in Pennsylvania situated at
(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) that he/she/they is/are the Executor(s) named in the Last Will of the Decedent, dated 08/03/2010 and Codicil(s)
thereto dated
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., pedente 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 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. _
C-> r1i
❑ NO EXCEPTIONS ❑ EXCEPTIONS C ® r
Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived byge3Tllowing sR~se (lanFbnd heirs (attach
additional sheets, if necessary): fst Y!?:
Name Relationship Address tta :
C7
CD
Form RW-02 rev. 10-11-2011 Copyright (c) 2011 form software only The Lackner Group, Inc. Page 1 of 2
Oath of Personal Representative Official Use Only
COMMONWEALTH OF PENNSYLVANIA }
} SS:
COUNTY OF Cumberland }
Petitioner(s) Printed Name Petitioner(s) Printed Address
Melissa M. McCord 2727 South Rosegarden Blvd.
Mechanicsburg, PA 17055
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 e De nt,,Petition 6 s I I wul dmini er the estate according to la .
Sworn to or affirmed an subscribed before Date
me I Iday of~ Date
By 110 14 AA k Date
or the Register Date
BOND Required? &S-)[1 NO To the Register of Wills:
FEES: LJ' Please enter my appearance by my signature below:
V
Letters $ Attorney ~Signatyru►re-
)Short Certificate(s)......... Q5 M
( )Renunciation(s) ~ rT1
Q -.1
( )Codicil(s) v
Printed Name: Michael L. fqn "
( )Affidavit(s) z' -5
Bond Supreme Court
P W a
Commission ID Number: 41263
Other
It— Firm Name: Banns Law dffi6, LC a
_,0 Address: 429 South 48th-_3reet~
`rl
l.J
Camp Hill, PA 17011
Phone: 717/730-7310
Automation Fee '
JCS Fee .50 Fax: 717/730-7374
TOTAL $ E-mail: mikebangs@verizon.net
DECREE OF THE REGISTER
Date of Death: 02/16/2013
Social Security No: 197-24-0667
Estate of Gertrude R. O'Toole File No: 21-13
a/k/a:
AND NOW, 13thOC c~dlJ~.'~ in consideration of the foregoing Petition,
satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary
are hereby granted to Melissa M. McCord
in the above estate and (if applicable) that the instrument(s) dated 08/03/2010
described in the Petition be admitted to probate and filed of record as toe Pap Will (and Codici ) of Decedent.
Register of Wills 1
i
Copyright (c) 2011 form software only The Lackner rou , Inc. bP.ge 2 of
H 105.805 REV I'1/I 11
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
WARNING: It is illegal to duplicate this copy by photostat cr photograph.
"
Fee for this certificate, 56.00 RECORDED C aIC_ OF I ~ T}I,, is to :ertifv that the information here gi\'en is
~1H~Ft \
REGIS i} Q{= cot(ectlti - copied from an original Certificate of Death
dnly filcd vOh me is Local Re(tstrar. The original
f, v c•-oi ic tte ~+ill be forwarded to the State Vital
La a;j Accords Office for petmnnctitfiling.
P 19398483 CLERK 0L__
FE67nh013
PHANS' CC' P a 9~cNTU4~,
Certification Number= 1. )cal R',,-istrar DatelSSned
GUMBEftCAOMMONO CO., PA
Type/Print In CWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
Permanent
CERTIFICATE OF DEATH
Black Ink nk State File Number:
1. Decedent's Legal Name (First, Middle, Last, Suffix) 2. Sex 3. Social Security Number 4. Date of Death (MO/Day/Y,) (Spell Mo)
Gertrude R_ O' Toole Female 197 - 24 - 0667 lK>r Cc 'k ( ---e,
Sa. Age-Last Birthday (Yrs) 5b. Under 1 Year 5c. Under 1 Da ''a" of Birth (M./Day/Year) (Spell Month) 7a. Birthplace (City and State or Foreign Cou
Months Day: Hours lvll- s Middlesboroxlh En and
/ 101 November 14, 1911 7b. Birthplace (C ry) Yorkshire
8- Residence (State or Foreign Country) 8b. Residence (Street and Number - Include Apt No.) 8c. Did Decedent Live in a Township?
Penns lean is 20 North 12th Street OYes, decedent lived in twP.
Ed. Residence (County)
Cumberland 8¢. Residence (Zip Cad.) 17 043 PD No, decedent lived within limits of Lemoyne city/bor.-
9. Ever in US Armed Forces, 30. Marital Status at Time of Death O Married Widowed 11. Surviving Spouse's Name (If wife, give name prior to first marriage)
O Yes ® No O Unknown O Divorced O Never Married O Unknow
12. Father's Name (First, Middle, Last, Suffix) 13. Mother's Name Prior to First Marriage (First, Middle, Last)
David Arthur Roush Margaret Flynn
14a. Informant's Name 14b. Relationship t. Decedent 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code)
o Melissa McCord Niece 2727 S_ RosegardeT Blvd_,Mechanicsburg,PA 17 50
_ .
C 15 a. P ace o Death Check on y one _
If Death Occurred in a Hospital: Inpatient If Death Occurred Somewhere Other Than a Hospital: t~ Hospice Facility Decedent's Home
o Emergency ROOM/Outpatient Dead On Arrival
ly _ Nursing Home/Long-Term Care Facility 0 Other (Specify)
ad 15b. Facility Name (If not institution, give street and number; 15c. City or Town, State, and Zip Code ISd. Couniy of Death
ManorCare Carlisle, PA 17013 Cumberland
16a. Method of Disposition O Burial Cremation 16b. Data of Disposition 16c. Place of Disposition (Name of cemetery, ere mafory, or other place)
- p Removal from State O D.nati.n February 19,
other (specify) Evans Crematory
2013
16d. Location of Disposition (City or Town, State, and Zip) 17a. Signatur of ral Service Licensee or Person in Charge of Interment 17b. License Number
Schaef£erstown, PA 17088 FS 012 849 L
E 17c. Name and Complete Address of Funeral Facility
3 Parthemove FH & CS =nc_ P.O. Box 431, ew Cumberland, PA 17070
18. Decedent's Education - Check the box that best describes the 19. Decedent of Hispanic Origin - Check the 20. Decedent's Race - Check ONE OR MORE races to indicate what
i- highest degree or I¢..I of school completed at the tlme of death. box that best describes whether the decedent ttnc~e decedent considered himself or herself to be.
O 8Th grade or less is Spanish/Hispanic/Latino. Check the "No" E* White O Korean
O No diploma, 9th - 12th grade box if decedent is not Spanish/Hispanic/Latino. O Black or African American O Vietnamese
O High school graduate or GED completed JM No, not Spanish/Hispanic/La[Ino O American Indian or Alaska Native O Other Asian
Some college credit, but no degree Q Yes, Mexican, Mexican American, Chicano O Asian Indian O Native Hawaiian
O Associate degree (e.g. AA, AS O Yes, Puerto Rican O Chinese O Guamanian or Chamorro
O Bachelor's degree (e .g. BA, AB, BS) O Yes, Cuban O Filipino O Samoan
O Master's degree (e:g. MA, MS, MEng, MEd, MSW, MBA) O Yes, other Spanish/Hispanic/Latino O Japanese O Other Pacific Islander
O Doctorate (e.g. PhD, EdD) or Professional degree (Specify) O Other (Specify)
. MD DOS DVM LLB, JD
21. D¢c¢d¢nt's Singl¢ Race Self-Designation -Check ONLY ONE to Indicate what the decedent considered himself or herself to be. 22, . Decedent's Usual Occupation - Indicate type of work
2a White O Japanese O Samoan done during most of working life. 00 NOT USE RETIRED.
O Black or African American O Korea" O Other Pacific Islander Admiili s t ra t ive As s l s t an t
O American Indian or Alaska Native O Vietnamese O Don't Know/Not Sure
O Asian Indian O Other ASlan O Refused 22b. Kind of Business/Industry
.=Jr O Chinese O Native H., lion O Other (Specify)
O Filipino O Guaa Man or Chamorro Federal Government
CE Pronounced Dead (MO Day/Yr) 23 b. Signature o Person Pronouncing Death (Only when applicable) 122, . License Number
ITEMS 23. - 23d MUST BE COMPLETED 23a. Data
PERSON WHO PRONOUNCES OR JJ
Tim of
CERTIFIES DEATH _z
23dr.-Date Signed (MO/Day/Yr) 24. Time of Death
U L'3 Q 25. Was Medical Examiner or Coroner Contacted? O Yes e8- No
CAUSE OF DEATH Approximate
26. Part 1. Enter the chain of events --diseases, Injuries, o mpl(cations--Shat directly caused the death. DO NOT enter terminal a nts such a cardiac a 7st Interval:
respiratory arrest, or ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional linesrif necessary Onset t. Death
IMMEDIATE CAUSE
(Final disease or condition Due to (or as a consequence of):
resulting In death)
b.
Sequentially list conditions, Due to (o as a consequence of):
if any, leading to the cause
listed on line a. Enter the
UNDERLYING CAUSE Due to (.r as a consequence of):
(disease or injury that
inmate. the events resulting tl.
In death) LAST. Due to (or as a consequence of):
S 26. Part IL Enter other significant conditions contributing to death but not resulting In the underlying cause given in Part I 27. Was an autopsy Performed?
S O Yes N
g 128. Were autopsy findings available
to c mplete the cause of death?
m oO Ves 22 No
29. If Fe ale: 30. Did Tobacco Use Contribute to Death? 31. Manner of Death
E Not pregnant within past year Or ~Yes O Probably atu ral O Homicide
S O Pregnant at time of death o O Unknown O Accid¢ni O Pending Investigation
O Not pregnant, but pregnant within 42 days of death O Suicide O Could not be determined
ti O Not pregnant, but pregnant 43 days to 1 year before death 32. Data of Injury (M./Day/Yr) (Spell Month)
O Unknown if pregnant within the past year 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:
O Yes O Driver/Operator O Pedestrian
O No O Passenger O Other (Specify)
L 39a. C¢r ifier (Check only one):
V Certifying physician - To the best of my knowledge, death occurred due to the cause(s) and manner stated
O Pronouncing 8. Certifying physician - To the best of my knowledge, death occurred at the time, data, and piece, and due to the cause(s) and m r stated
O Medical Examiner/Coroner - he basis of examination, and/or investigation, in my opinion, death occurred at the time, date, and place, and due to the cause(s) and --stated
Signature of certifier: Title of certifier: ~ - 0 License Number: O C?(O lZ'< r - C.
39b. Name, Address antl 21p Co Person Completing Cause of Oeath (Item Z., 39c. Data Signed (MO/Day/Yr)
r I C i n CcerliSle 1~ Y c~ g c e3
40. Registrar's District Number 41. Registrar's ature yy~ 42. Registrar Flie Data (MO Day r)
43. Amendments
O
C 105-143
Disposition Permit Na- / (`PP,1 -5,5L, (7) REV 07/2011
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1, GERTRUDE R. WTOOLE, of the Borough of Lemoyne, Cumberland County,
Pennsylvania, declare this to be my last will and revoke any will previously made by me.
ITEM I. 1 direct that all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable
after my death as part of the expense of the administration of my estate.
ITEM II. All death taxes (and interest and penalties thereon) imposed as a result of my
death shall be paid by the person receiving the property to which such taxes are attributable. For
purposes of this paragraph, the term -'death taxes" -,ha!,' tnear± *c_Jcn-il c-tate tax and any
inheritance or estate tax imposed at death by any state of the United States.
ITEM III. In the event that I have any personal property of any nature, I direct my
Executrix, Melissa M. Leggett, to divide those among those individuals that she deems
appropriate. She has the sole and absolute discretion to divide those items.
ITEM IV. I give, devise, and bequeath all the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate in equal shares to CATHERINE E.
LEGGE'T'T, JOLL McCORD, DONNA LYNN FREAS, KATHLEEN ANN TYLER, or the
survivor of them who shall survive my death by thirty (30) days. I have already provided
Catherine E. Leggett an advancement in the amount of $33,250.00. Therefore, Joel McCord,
Donna Lynn Freas and Kathleen Ann "Tyler, or the survivor of them who survive my death by
thirty (30) days. should each receive 533,250.00 to equalize the advancement that I made to
1 1~
1 1
Catherine E. Leggett and then the remainder, if any of the estate, would be divided evenly among
CATHERINE E. LEGGETT, JOEL McCORD, DONNA LYNN FREAS, KATHLEEN ANN
TYLER, or the survivor of them who shall survive my death by thirty (30) days as set forth
under this Item IV.
ITEM V. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM VI. I appoint MELISSA M. LEGGETT executrix of this my last will. Should
Melissa M. Leggett predecease me or otherwise fail to qualify or cease to serve as executrix of
this my last will, I appoint DONNA LYNN FREAS executrix of this my last will.
ITEM VII. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, 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 1
-r
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM VIII. I direct that my personal representatives and fiduciaries shall not be
required to give bond for the faithful performance of their duties in any jurisdiction.
/7
IN WITNESS WHEREOF, I have hereunto set my hand this day of
'2010.
.
GERTRUDE R. O'TOOLE
3
The preceding instrument, consisting of this and THREE other typewritten pages, each
identified by the signature of the testatrix was on the date thereof signed, published, and declared
by GERTRUDE R. O'TOOLE, 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.
~elc "I
4
COMMONWEALTH OF PENNSYLVANIA )
(SS:
COUNTY OF CUMBERLAND )
The undersigned, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, does hereby acknowledge that I signed and
executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed,
i
GERTRUDE R. O'TOOLE
S avor7 or affirmed to and acknowledged
betore me by the testatrix named above
r'J .Y
this day, of'Lttk L
~x 2010. Li
P r;itsu;
13'oTi seal
r 1"t r f a 0 ,dory PuL lac
Notary Public 2011
Pennsylvania Association of Notaries
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND
WE, _ M and the
witnesses whose names are signed to the aached 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 she signed it willingly and that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as
witnesses; and that to the best of our knowledge, the testatrix was at that time 18 or more years of age, of
sound mind, and under no constraint or undue influence
l.
Sworn or affirmedjt and acknowledged
11
betbr ne this _ day of
2010.
All
Notary Public , t
C,~4Yi w r.,'UVEALTH OF PENNSYLVANN,,A.
ot Pi
Werd~ K.
'A/ov~~s
Ponnsyivai~s~; F~SS~ci~tiiar~ vi tv~r~jis/Er~i:
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