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HomeMy WebLinkAbout03-12-13•~' a r_ p, PETITION FOR GRA~1T OF LETTERS REGISTER OF WILLS OF .t~ryt ~_v~a ~-~_ COUNTY, PENNSYLVANIA Petitioner(s) Warned below, .who isiart 18 years of age ar older, apply{ies) for Letters as specified belor~v. and in support thereof aver(s) the following and respectfully request(s) the grant of Letters in the appropriate form: Decedent's Information Name: ,J ~N E ~• M G r,~t~,e.~-c~.~ a/k/a: a/k/a: File No• ~ ~ ~ ~ 3 (Assigned by Register) Social Security No: „2,,~G l ~ r'ga7 Date of Death: a ~ F.~ea~,,R.~.Y-~ ~., o I -~ Age at death: Decedent was domiciled at death in C_ ~ ,~.e~ R ~,a.,,~ D County, "~A (ware) with his/her last principal residence at 3 a .~"_ i,~ ~s L>rY "~ ~,,,, r, ~ ~3 2~ 2., , r'VbEc rr-A-,~UtLtD ~~~- ~ -7a~~ ~..,a~~w-~`i- Street address, Post Office and Zip Code City, Township or Borough County Decedent died at 3 ~-.5 W ~..~~~` ~ ~~~~T ~3 z~ Zl Nt~~rrn-~~~s e~c,~~~-.~ t7+~.~3' Cu.w~~~~TJ Pro- 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 ...................... .................................. . TOTAL ESTIMATED VALUE... . $ ~-7 . ~9 c7 D $_T~T ~a o Real estate in Pennsylvania situated at: ~~'l. (Attach nddirional sheets, if necessary.) Street ad ress, 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 . ~ - ~ - ~ a D p and Codicil(s) thereto dated ,~ .; n ~ State relevant circumstances (eg. renunciation:, death ojexecutor, etc.) 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 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 ado fed; and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. ~O 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 absentiu, durance minoritute 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 parry to a pending divorce proceeding wherein the grounds for divorce had been established as defined in 23 Pa. C.S. 6 3323(e) and was neither the victim of a killing nor ever adjudicated an incapacitated person. ...~ -... ~p CD Petitioner(s), after a proper search has/have ascertained that Decedent left no Will and was survived by fOl~bwing spott~(if an~n~eirs (attach additional sheets, if'necessary): m ~ ~ "' :h~r~- ^ NO EXCEPTIONS ^ EXCEPTIONS Name Relationshi f V rr~ 3s.. dms ;x~ C:.~ ''~ ~ C~ - '~ ~ ,t ~, ,~,.,~ t7 -~ -~ !`.._ ~' ~~ ~ to d :; -~ Form RW-~2 rev. !0/11/1011 Page 1 of 2 r r `~ Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY O F C u,~- t3r,,.~ tr~,3 ~ } 'I. w ,ry e Only c~ s ~ ~ ~ ~ ~ ' K ~° ~,- r Cn ~ ~' :~ ~ ~ ~ _,,,,~ t~ c;3 ... . .. r j, t ~r~ ~~- ~ .~„r, Wrt Petitioner(s) Printed Name Petitioner(s) Printed Addre ~-~% ~°-~ ~ Nit-~~-- ~~ ~~' Y ~ ~~ ~ o t.cS' ~ ~ L , , 1 6- 1~ M- r° - 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 according to law. Sworn to or affirmed and subscribed before ~.li ~ Date _'~ - ~ - ~ 3 met ~ day of ~~;~ Date _~ -- ~f ~ / 3 $ - Date '~ _ •~=~3 Fur the Register Date BOND Required: Q YES ~ NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters ...................... $ ( )Short Certificate(s)..... . ( )Renunciation(s)........ . ( )Codicil(s) ............ . ( )Affidavit(s)........... . Bond ........................ Commission ................. . Other ....... Automation Fee . ............. . JCS Fee . ................... . TOTAL ..................... $ 0.00 Attorney Signature: Printed Name: Supreme Court ID Number: Firm Name: Address: Phone: Fax: Email: DECREE OF THE REGISTER Estate of f File No: ~ 1 ~ ,/ ~" ~~ ~ G lu- ~ AND NOW, ~~ , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ ~f" e ~ !'' are hereby granted to /'~ P_ U~ ~ 1. ~'- ~-k~a- u~an ~.. X/~~ Clad. ud/ Lr ~/.~"~ in t e above estate and (if applicable that the instrument(s) dated ~ ~/"~.Jart/ L 20eo described in the Petition be admitted to D{obate and filed of record, as the last Will (and Codicil() of Decedent. Register of Wills Form RW-02 rev. 10/11/2011 H 105.805 R i -(9~l In ~~ LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplica#e this copy by photostat or photograph. RECOR~~~ ~FF1~~' OF Fee for this certificate, $6.00 R~~S ~ ~ T~ R Q ~' "~ ~ -~ ~ S ii,,iii~"""""~-- This is to certify that the information here given is II ~ZH OF p-"' P ~.~217620 Certification Number Type/PNnt In Permanent Black Ink 1. Decedent's Legal Name (First, Jane A. Mehargue Sa. Age-last Birthday (Yrs) Sb. 88 M~ Sa. Residence (State or Foreign < Penns lvania 8d. Residence (County) Cumberland 9. Ever In US Armed Forces? Q Yes ®No Q Unknown 12. Father's Name (Ftrst, Middle, Rav M. Houseal t Iiii1,11~~P _ Fyyf __ correctly copied from an ongmal Certificate of Death ~~ ~3 ~~~ ~ ~ ~ m ~~~ y` _. _ _ ~ =, duly filed with me as Local Registrar. The original t f ~ ' _ ~ =_. ~ certificate will be forwarded to the State Vital a; v ~= ~ Records Office for permanent filing. CLARK 0~ ~ *' _ ' *,,~` N S' C ~ ~;~~' ~'99l ~ ~~a~ii,,, ~ ' i(1 C~BERI.ANC CC., '°-MENTOR 1 ~~ -~"""""""'iii Local R istrar Date Issued COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS Ar sIr ATV .. Harrisburg, PA 17109 17c. Name and Complete Address of Funeral Facility Auer Cremation Services o£ Penns lvania Inc. 4100 Jonestown Rd. Har ~ 18. Decedent's Education -Check the box that best describes the 19. Decedent of HispanicOrigin -Check the -°- highest degree or level of school completed at the time of death. box that best describes whether the decedent " ^ Q Bth grade or less No is Spanish/Hlspanic/la[ino. Check [he Q No diploma, 9th - 12th grade box if decedent Is not Spanish/Hispanic/Latino. ® High school graduate or GED completed ®No, not Spanish/Hlspanic/Latlno Q Some college credit, but no degree Q Yes, Mexican, Mexlun AmeHUn, Chicano Q Associate degree (e.g. AA, AS) Q Yes, Puerto Rican Q Bachelor's degree (e.g. BA, AB, BS) Q Yes, Cuban Q Master's de;ree (e.g. MA, M5, MEng, MEd, MSW, MBA) Q Yes, other Spanish/Hispanic/Latino Q Doctorate (e.g. PhD, EdD) or Professional degree (Specify) S If Death Occurred in a Hospital: Inpatient Eme eney Room/Outpatient Dead on Arrival : Nursin Home/Con -Term Care Facili Other (Spec) ) County of Death 15d 15b. Facility Name (If not instkution, give street and number; . i5e. City or Town, State, and Zip Code Cumberland Bethany Village Mechanicsburg, PA 17055 i h ~ Sba. Method of Disposition Burial Cremation 16b. Date of Disposition a er p 16c. Plau of Disposition (Name of umetery, crematory, or ot Q Removal from State Q Donation 3 ~-$~ 3o t 3 Cremation Society of Pennsylvania ~ Other (Specify) 16d. Location of Disposition (City or Town, State, and Zip) 17a. Signature of ral Service Licensee or Person in Charge of Interment 17b. Ucense Numba FD 013376 L Dltl Decedent cave Ina lownsmpr Yes, decadent Ilved In No, decedent lived within limits of twp. I. Mother's Name vnor to r~rsc marnega 1~•.•ti ••••~~•a. --'-. Ethel Trullinger k. laformant's Mailing Address (Street and Number, City, State, Zip Code) g Susan Kin •..- . -...•.- . --daughter P .O. Box 30243 Edmond OK 73003 ......... ............................ . .............................. G ......................... g.......... ........... ..... .. ~:...au_o ea ec on y, one .............................. .................................... ... ......... .............. Decedent's Home `~~ -If Oeath Occurred Somewhere Other Than a Hospital: ~ Hospice Facility a. . MD DDS OVM LLB JD 21. Decedent's Single Race Self-Designat ion -Check ONLY ONE to Indicate what the decedent cons) ® White Q Black or Ahican American Q Japanese Q Korean Q Samoan Q Other Pacific Islander Q American Indian or Alaska Native Q Vietnamese Q Don't Know/Not Sure Q Asian Indian Q Other Asian Q Refused Q Chinese Q NatNe Hawaiian Q Other (Specify) Q Filipino Q Guamanhn or Chamorro ITEM a - 23 BE COMP D 3a. Date Pronounce Dea Mo Day r BY PERSON WHO PRONOUNt6f OR O } ~ L3 Domestic QN So 0329 L ~~a. aiau ~.a•.w .~..,. ..ter, .. , _ .. _.... _ - - 2 r '~ _. 25. Was Medical Examiner or Coroner onta e CAUSE OF DEATH ~ Approximate Interval: Part 1. Enter the chain of events--diseases, injuries, or complications--that dlrectN caused the death. DO NOT enter terminal events such as cardiac arrest. Add additional lines If necessary Onset to Death 26 li e . n . . Enter only one cause on a VIATE E R respiratory arrest, or ventricular fibrillation without showing the etlotogy. 00 NOT ABB ~ ~ ' ~ 1 ^ y f"`l Y T ~ ~" j 1= N°~ 1 a N ~ ~ ~N A R ~ U IMMEDIATE CAUSE --_~_~_~_> a, (Final disease or condition -- Due to (or as a consequence of): resulting in death) b. Sequentially list conditions, Due to (or as a consequence of): If any, leading to the cause listed on line a. Enter tM c• ( Due to (or as a consequence oi): _ W UNDERLYING CAUSE (disease or injury that i t c initiated the evenu resulting d. AST £ Due to (or as a consequence of): - v . In death) L Enter other significant condkions contributing t Part 11 26 o death but not resulting In the underlying cause given In Part 1 27. Was an autopsy performed? Q Yes No a . . 28. Were autopsy findings available ~ ~ to complete the cause of death? '~' Q Ves No 29. If Female: 30. Did Tobaeeo Use Contribute to Death? 31. Manner of Death ~ Natural Q Homicide Not pregnant within past year th f d ~ Q Yes Q Probably Q No ~ Unknown Q Accident Q Pending Investigation uld not be determined C ~ ° ea ] Pregnant at time o Q Not pregnant, but pregnant within 42 days of death nant 43 days io 1 year before death t b 32. Date of Injury (Mo Oay/Yr) (Spell Month) o Q Suicide Q I - prsg u Q Not pregnant, Q Unknown if pregnant within the past year 33. Time of Injury 34. Place of Injury (e.g. home; construction site; farm; school) 35. Caution of Injury (Street and Number, City, State, Zip Code) 36. Injury at Work 37. If Transportation Injury, Specify: 38. Describe How Injury Occurred: ~,•~ ' ~ Yes Q Driver/Operator Q Pedestrian Q No Q Passenger Q Other (Specify) 39a. Certifier (Check only one): ~' Certifying physician - To the best of my knowledge, deat h occurred due to the cause(s) and manner stated the cause(s) and manner stated t d d ue o Q Pronouncing & Certifying physician - To the best of my knowledge, death occurred at the time, date, and place, an ted ta and place, and due to the cause(s) and manner s date d at the time Q Medlul Examiner/Coroner - On the basis of examinatio , , ,and/or Investigation, In my opinion, death occurre J ^ 7d3 32 ~ 7~ G° SGT . Title of urtlfier• M ' ~ • Ueense Number: /j'- Signature of urtifler: 39c. Date Signed (Mo/Oay/Yr) 39b. Name, Address and 21p Code of Person Completing Ca ' of Death (Item 26) T?d f-f ~ ( 9 r1' ~ 9 3 /<~ ~ ' 2 -i $ 30 • C• S'C F~ Lcl.A 2 -~ ~ tJ (~J.tr,~/i/t y ~2 4 . Registrar Flle Date o ay r ~ ~ _ ~•~ a~ t .e,A 40. Registrar s District Num er 41. Registrar s Signatura J ~i ~ -~ a ~ 43. Amendments M105-143 ~.LI~ s ss-s~.~ ^ s. v^ 2. Sex 3. Social Security Nui Female 209-12-9807 :ar Sc. Under 1 Da 6. Date of Birth (MO/Day/rs~ Days Hours Minutes August 16, 1924 Sb. Residence (Street and Number -Include Apt No.) 325 Wesley Drive Apt. 3202 8e. Residence (Zip Code) 17055 arital Status at Time of Death Married Wklov Divorced Q Never Married Q Unknown 20. Decedent's Rau -Check ONE OR MORE Taus io Indicate wnac the decedent considered himself or herself to be. ® White Q Korean Q Black or African American Q Vietnamese Q American Indian or Alaska Native Q Other Asian Q Asian Indian Q Native Hawaiian Q Chinese Q Guamanian or Chamorro Q Filipino Q Samoan Q Japanese Q Other Paelflc Islander Q Other (Specify) •self to be. 22a. Decedent's Usual Occupation -Indicate type of worl done during most of working life. DO NOT USE RETIRED. Housewife February 28 ate or Foreign Coun Disposition Permit No.~ ~ ~j~ `iv REV 07/2011 .~~ ~=. ~ ~' Q ~ ~ ~ ~~ m ~ ~ ~ ~, ~s ~ ~„ r- r- ~ ~ r--' ~ ~~~~ n~ ~ rv OATH OF SUBSCRIBING WITNESS( ' ~ ~ REGISTER OF WILLS ...~ --~ C..,> t... , ~., ~„1 ~..m.~ CUMBERLAND COUNTY, PENNSYLVANIA ~''• ~~ Estate of Jane A. Mehargue Deceased James D. Bogar , (each) a subscribing. witness to (Print Name/s) the ~ Will ~ 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 day of , Deputy for Register of Wills (Si ature) One West Main Street (Street Address) Shiremanstown, PA 17011 (City, State, Zip) Executed out of Register's Office Sworn to or affirmed and subscribed before me this ~~ ~ day of ~Q rC~i c.~C~ l ~ l Notary Public My Commission Expires: /al~~l ~~ (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 OTARIAI BETH B. IENGEI, NOTARY P116UC SHiREMANSTOWN BORO, Ct1MBERtANO COUNK MY COMMISSION EXPIRES DECEMBER lY, 2ti15 2~ ~3 a9~1 OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS C ~,~.~,,,~ ~ ~, ~~ COUNTY, PENNSYLVANIA Estate of _~ A-,y C ~, Imo. ~ t~t,A-,t~~>~1 ,r-- ,Deceased ~ ~7 ~ t .. f~ G~ 2~ and , (each) being duly qualified according to law, depose and say~,s~ that ~/ he /they as were well- acquainted with ~ ~- ~ J q~tJF~ ~ . ~~-,~c~. ~ and are familiar with the handwriting and signature of the decedent, and that the signature of `5~,~ ~ i4- f-~-Erra-,e. c~.~ to the foregoing instrument purporting to be the Last Will and Testament/Codicil of ~ ~-,-,s ~ A~. ME ~,A~2~ F is in his own proper handwriting. (Signature) (Street Address) (Signal ~ c~ bf E/~-R- r ~ 2~ (Street Address) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this ~ ~~' day of , ~~ uty for Register of VViIIs ~ tom. P .~-~= ~. C_ ~. Pr4 ~ ~ ~ 1 ~ (City, Stale, Zip) © `.,' ~ M ~~ ~ ~~ c~- ~~~ _ ~~ ~, ,z rn w rU r°~°~ r+~c ~~ -~; ~~ ~ r~ ~ ~ Form RW-04 rev. 10. I3.Ob ~~ c-. ~ c..a ~ t`r"t ~~ ~ ~'~ LAST WILL AND TESTAMENT m ~ " ~' ~' ~' ~ ~ ~ ~ ~~ ~., JANE A. MEHARGUE ~' =~ 4.~ ';:: .~.~ ~~9 I, JANE A. MEHARGUE, of Fairview Township; York ~un~£y~ 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, unto my husband, DAVID G. MEHARGUE, provided he survives me by sixty (60) days. SECOND: Should my husband, DAVID G. MEHARGUE, prede- cease me or die on or before the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remain- der of my estate of whatever nature and wherever situate, includ- ing any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, to my children, JANE ANNE MEHARGUE, SUSAN L. KING and JUDY L. KISER. Should my daughter, JANE ANNE MEHARGUE, predecease me, I direct that her share under this, my Last Will and Testament, pass, in equal shares, to my daughters, SUSAN L. KING and JUDY L. KISER. Should my daughter, SUSAN L. KING, predecease me, I direct that her share under this, my Last Will and Testament, pass, in equal shares, to my daughters, JANE ANNE MEHARGUE and JUDY L. KISER. Should my daughter, JUDY L. KISER, predecease me, I direct that her share under this, my Last Will and Testament, pass to her issue per stirpes by representation. THIRD: Should any of my grandchildren not have attained the age of twenty-five (25) years at the time for distribution to him or her, I give, devise and bequeath the share of each such grandchild to my hereinafter named Trustee or Trustees, IN SEPARATE TRUSTS, to hold, manage, invest and reinvest the shares so received, and to use and apply from time to time such portion of income and principal for the said grand- child's education (including college, trade school or other similar training or education), as my Trustee or Trustees, in their sole discretion, deem advisable. Any income or principal not so applied shall be dis- tributed to each grandchild when he or she attains the age of twenty-five (25) years. In the event any of my grandchildren die prior to the termination of the Trust set forth herein for their benefit, the interest of my grandchild in said Trust shall cease with any income and principal being divided evenly between or among that deceased grandchild's natural brothers and sisters or the separate trusts established hereunder for their benefit and, in the absence of any natural brothers and sisters, to my other grandchildren in equal shares. FOURTH: In addition to all powers granted to 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 2 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. (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. FIFTH: I nominate and appoint SUSAN L. KING, as Trustee of the hereinabove described trusts. In the event of the death, resignation or inability to serve for any reason whatso- ever of the said SUSAN L. KING, I nominate and appoint JUDY L. KISER, Trustee of the hereinabove described trusts, who shall serve without bond and shall receive fair or reasonable compensa- ', tion. SIXTH: 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. SEVENTH: All interests hereunder, whether principal or 3 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 beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. EIGHTH: I nominate and appoint my husband, DAVID G. MEHARGUE, Executor of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said DAVID G. MEHARGUE, I nominate and appoint JANE ANNE MEHARGUE, SUSAN L. KING and JUDY L. KISER, Co- Executrixes of this, my Last Will and Testament. I direct that my Executor, Executrix or Trustee, 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 f day of i ~ 2000. SEAL) J A. ME GUE ~. 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 4