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HomeMy WebLinkAbout04-29-13 Reset 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 request(s)the grant of Letters in the appropriate form: Decedent's Information n Name: Richard E.Cover File No: oC I I J a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 165-26-5517 Date of Death: March 31,2013 Age at death: 85 Decedent was domiciled at death in Cumberland County, Pennsylvania (state)with his/her last principal residence at 2100 Bent Creek Boulevard 17050 Mechanicsburg Cumberland Street address,Post Office and Zip Code City,Township or Borough County Decedent died at 2100 Bent Creek Boulevard 17050 Mechanicsburg 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 $ 263,000.00 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. ... $ 263,000.00 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)he/she/they is/are the Executor(s)named in the last Will of the Decedent,dated November 30, 1979 and Codicil(s) thereto dated a to the death of the initial executrix,BetbZ T Over,on October 16, 2011 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(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 0 EXCEPTIONS B. Petition for Grant of Letters of Administration (If applicable) c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente lite,durante absentia,durante minoritate If Administration,c.t.a. or db.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 bee Li-t_-stablished,4s defined in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated per@- c�a � rn 0 NO EXCEPTIONS 0 EXCEPTIONS 8 Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the fd 1g Buse any)�d ht irs(attach additional sheets,if necessary): r � M CD °,, Name Relationship Ar dr s `f -n Form RW-02 rev.10/11/2011 Page I of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF CUMBERLAND } Petitioner(s)Printed Name Petitioner(s)Printed Address Michael S.Cover 1817 Foxhunt Lane Harrisburg,PA 17110 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 ner(s)will well and truly administer the estate acc rding to law. Sworn to or a firmed and ubs cribed before I/� �' Date '7 �g met -fla y of ,CaV t J Date By: Date For the Register Date BOND Required: 0 YES Q NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters . .. . . . . . ... . . . . . . . . . . . $ 355.00 Attorney Signatur ( 5 ) Short Certificate(s).. . . . . 25.00 ( )Renunciation(s).. . . . . . .. ( )Codicil(s). . . . . . . . . . . . . ( )Affidavit(s).. . . .. . . . . . . Co M n CS Bond.. . . .. . . .. .. . . . . . . . . . . .. Print Name: John A.Feichtel Commission. . . . .. ... . . . . . .. .. Supreme Court M Other . .. .. . . ID Number: 77426 — C . . . . . . . . Firm Name: Saidis Sullivan&Roget - - -7; . . . . . . Address: 635 N. 12th Street 4ui ¢440 ' . . . . . . Lemoyne,PA 17043 ^� -'i; c0 _ . .. . . . . . F-4 'r1 . . . . . . . . Phone: 717-612-5803 Automation Fee. . . . . . . . . . . .. . . 5.00 Fax: 717-612-5805 JCS Fee. . . . . . . . . . . . . . . . . . . . . 23.50 Email: j .ic-htel ccr-attnrneys nom TOTAL. . . . . . . . . . . . . . . . . . . . . $ 408.51 L DECREE OF THE REGISTER Estate of Richard E.Cover File No: a/k/a: AND NOW, OL9 ,�b13 , in consideration of the foregoing Petition, satisfactory proof having been p sented 6fore me,IT IS DECREED that Letters Testamentary are hereby granted to Michael S.Cover in the above estate and(if applicable)that the instrument(s)dated November 30 1979 described in the Petition be admitted to probate and filed of record as the last Will(and Codici (s))of Decedent. Register of MIN Form RW-02 rev.10/1112011 Page 2 of 2 H105.805 REV(9/11) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. RECORD D OF"!CE OF Fee for this certificate, $6.00 �s, This is to certify that the information here given is s _ L S L1LE, �p�ZH OF pE� correctly copied from an original Certificate of Death (1013 APR �� duly filed with me as Local Registrar. The original FA t .; z certificate will be forwarded to the State Vital t.°v` n� Records Office for permanent filing. CLERK 0 1= P 19475346 ORPHANS- COURT -���9lMENTOE,��P~ltY Certification Number CUMBERLAND CO.g PA """" Local Registrar Date Issued Type/Print In COMMONWEALTH OF PENNSYLVANIA•DEPARTMENT OF HEALTH•VITAL RECORDS Permanent Black ink CERTIFICATE OF DEATH 1.Decedent's Legal Name(First,Middle,last,SufNq 2.Sea 3.Social Security Num' State File Number 4.Date of Death IMO/Day/Yr)(Spell Mo) iueharhd E. Cover Male 165-26-5517 March 31 2013 5a,Age-Last Birthday(yrs) Sb.UrMer 1 Year Sc.Under 1 D 6.Date of Bmrt (Ma/Oay/Year)(Spell Month( ]a.Birthplace([Ny and Stxe or Foreign CW ntry) Months Day Hours Minutes Haul$ P 85 NO---nher 24, 1927 7b."I'mPlace(County) Dauphin lvania Reddegca bte or Ign Cm,mr j Bb.Relic—(Street and Number-Include Apt NO.) 8c.Did Decedent liw In a Townshlpi ylvanla 2100 Beat Creek Blvd @Yes,dmedemllwdk Silver Spring e exit mz�annn� P. Be.Resbeme 121,Code) 050 DNO,decedent it ed wkhe Nmm of 9..aEtder In US Armed Forces? 10.Martial Status at Tlme a Death ❑Maned Wieawee 11.SurvMn dry/bom dices D No D Unknown D Dw.rced 0 Never Manned Uqp g Spouse's Name(lf wife,glue name Prkr to Rrst..M.el 12.Father's Name(First,MWtlle,last,Sunk) 13.Mmhw'c Name Prior to First Marriage(First,Middle,Lash Maori aim Wallower SIa.Informant's Name lab.Relationship to Decedent lac.Informant's Mailing Address(Street and Number,City,State,Lp Code( 6 Michael cover 11117 rM Htr$Iar>' t ..........._..............._._...................... ........................... ,FIR 17110 .........................................a �...._�5...._...... s If Death Omumee ln•XOSpkal: I71n tknt 1a 'arid Pa ..... ............................ ...._........... .............. �.. 3 il(OeaM Oaumed Somewhere Other Than a Xospkal: 17 Nmpke Fad(x1jent J Eme envy lif Ftiustiturm Dead onAMwI Nursing XOme/Long-Term Care Facility Other fSP cRY) Oeredent's Home a4 156.Fas1Nry Name Ilt not Bentbq glee street antl number; 115c. Iry or TOwn,State,and Dp_. Bridges at Bent Creek Ise.cppmy.f Dean 3 Me.Method ofOlsPOaRlon Burial FL °k'cha2ucs Penns lvania 17 D Removal from Stale `][Cremation I6b.Dxe o/DNpwitlon 16c.%ace x pbpoNNOn(Name of umet p ❑Ibnatlpn dry,crematory,or other place) gL ahet(5mm) 4/2/2013 Hollinger creimtoxy 16tl.Location. of DI1PozWon(Otym Town,State,and ZI a Licensee or person In me cal I)e.Slpture of Fu I rye of Interment 17b.liceme Number sE Mt. Holly Springs, PA 17065 - z - a 17c.Name and Comylet.Add-ofFUnenlF.011, FD 130907 Mal zzi csbur 17055 18.Decedent'Education-Chad the boa thrt best desnibes the 19.Decedent Ispank Origin-Check the 20.Decedent's Race-Cheri ONE OR MORE races to Indicate what highest degree w keel of school completed at the Lime of death. boa that best d.-I-s whether the decedem the decedent considered himself or herself to be. D Ith grade w less Is SpanlshMkomit,latarm.Checy,the•No- White ❑Rorcan 0 NodiPbma,graduate or grade GED boa X decedent is not SwnkhMNPank/Leon.. Black or African American 0SomechedgraeditautGEdegree completed 8 NO,ratSpanJsh/WSpank/Lxtbro Vietnamese college D Some_degreedit,but, Sj ❑Yes,Memcan,Mexican American,Chicano ❑Askn Indlaheian or Alaska Nadve D Other Apace ❑B.chel.a degree le.e.AA,Asl D Yes,Puerto Rican ❑Natke Hawan,n Bachxoh degree D Chinese D Guamanian or Chamorro ding.BA,AB,BSI ❑Yn,Cuban D Filipino D Samoan Master's degree I.g.MA,M5,MEng,MEd,NSW,MBA) D Yes,other Spankh/Hlspmlc/latino D Japanese Dottarete ley PhD.EEDI ar Protetsi.nal degree 11 Other Pacific Islander e. MO DDS DVM LLB JD (S-'fig) ❑Other(Sp-if,) 21.D cedent's Single pace Self-Oasignatbn-check ONLY ONE to Indicate what the decMent considered himseX or herself to be.22a.Decedent's Usual Occupation-Indicate type of work White done durin D glad w African American D ❑Samoan g most m working Ilk.DO NOT USE RETIRED. ❑Rwean 0 OtherPadfic-nder Insl3ranoe Agent D American Indian m Alaska Net" 0 Vietnamese D Don't Arasv/Not Sure 0 Mum IrMlen D Other Asian D Refused 0 Chine. D Natke Hawaiian 0 Other(Spec 22b.Rind of Business/Induxry D Filipino 13 Guamanian w ch-onro m) Insurance REM'S4D I WHO MUST BE PRONOUNCES ON 23a.Date Pronounced Dead IMo Day r) Is..Signature of Person Pron.umlng Death(Only when aPplk able 23c.License Number It PERSON WNO PRONOUNCES CER71FlE5 DEATH 23d.Date Sigmd(M./pay/Yr) 24.Time of Death ZS.Was Medical Eaamimr or Coroner COntadedi ❑yes No CAUSE OF DEATH 26.Part I.Enter the chain of e_ve�disea.s,Injuries,or compllcaNOns--tMl direct c Aresgntory arrest,or venhkVlar flbrillatlOn without showln the etb IY aused the death.DO NOT enter terminal 8 k6Y.DO NOT ABBREVIATE.Enter only one cauu on a line Add sddltbnal Ilnet H neces.ry (MMEDIA TE -------------- I� Final 11 condition refdeing In f exh) I, w a t/� O� m."ne, oft: b. seRuenLi.Ry Ila conditions, Due to for as a consequeme ott: it am.leafing ro the nose Rated on Une a.Enter the c. UNDERLYING UUSE (diaease w injury that Due to(or as a consequence of): F InRlated the events resulting d. In death)IAST. Due to for as a cornequeme oq: C26.Part II.En4r othetsk IRn t trl H t d th bet rat Muld,In the underlying cause given In part I ZJ.Was an autopsy pP ed7 F ❑Yes .B NO m 28.Were autoPsY Rndblgs awllable to complete Me ore f death] .� 29.If Female: W.Did Toby o Use Contribute to Deatn7 31.Manner of Death D Yes No E 0 Not Pregnant wlNln past Year 8 0 Pregnant x time of death 0 Yes 0 probably ❑Nx.rsl D Homicide 0 Not P."I,but Pregnant wamn 42 days of death ❑No )a Unku.wn D Accident 0 Pending Ineesngatwn D Not pregnant,but pregnant 43 days to l Year before death 32.Date of Injury(M./Day/Y'r ❑Suicide D Could not be determined Unkn.vm lf Pregnare wI0,m the past year I(Spell Month) 33.Time of Injury 34.Place of Injury leg.home;construction site;hm,;school) 3S.LmaUon of In'u Street and Number, 1 ry 1 tray,State,Zip code( 36.Injury at Work 37.It Transp,utkn Injury,Specm: 38.Describe How Injury Occuned: 0 Yes 0 Driver/Operator D Pedestrian 0 NO 0 Passenger 0 Other jSpmlfy) 39a.QrtlNer(Cheri only one): �2 C'nZng PhYSklan-To the best d my knowledge,death mcurred due to the cau.(s)and manner stated D Pronouncing Ik C-n"bg Phyakum.T the hest of my knowledge,death incurred at the time,date,and pace,and due to the uu.(s)and manner stated ❑Medical Enmhser/Coroner-On t of as nation,and/or InwAigetk 1,in my.pinion,death.murred at the time,date,and place,and due to the cause($)and manner stated Signature ofmnmer: as TRleofceulmer: /1'79 License Number:1]12 WP`7]] 39b.Name,A r.and Zip Code m e Completin Cause of Death(Item 26 3 e 39c.Date S M( /D"11r) 40.Reghtr s Dist"Number al.Reglxrars pan",I' / 1 I .y ( 42.Registrar File Date(M.Day r) 13.Amendmmts '1 )4 3 "t3 c Lw M rn LAST WILL AND TESTAMENT m 70 r OF RICHARD E. COVER I , RICHARD E. COVER of the Borough of Re anicoburgc," y ;f� Cumberland County, Pennsylvania, declare this to btr4my Last ., Will and Testament, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I devise and bequeath all of my estate of whatever nature and wherever situate unto my wife, Betty L. Cover, pro- viding she survives me by sixty (60) days. III - Should my said wife fail to be living on the sixty-first (61st) day following my death, then I devise and bequeath all of my estate of whatever nature and wherever situate unto my issue per stirpes. IV - I appoint my wife, Betty L. Cover, Executrix of this, my Last Will and Testament. Should my said wife fail to qualify or cease to act as such, then I appoint my son, 'Michael S. Cover, to act in this capacity. Neither of my personal representatives shall be required to post bond in this or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this , the day of o� ,u,{, 1979. _..,(SEAL) Richard E. Cover ARNOLD,SLIKE&BAYLEY ATTORNEYS AT LAW C­1 H111,PENNSy Ynrce >oi Page 1 Signed, sealed, published and declared by RICHARD E. COVER, Tes- tator therein named, on this and one (1) other sheet of paper as and for his Last will and Testament in our presence, who, in his presence, at his request and in the presence of each other, have hereunto subscribed our names as attesting witnesses. �? )4 pa Name Address Na e Address ARNOLD,SLIKE&BAYLEY ATTORNEYS AT LAW - Cl—H...,PExESy—V �10 Page 2 COMMONWEALTH OF PENNSYLVANIA) : SS . COUNTY OF' CUMBERLAND) I, RICHARD E. COVER , the testator whose name is signed to the attached or foregoing instrument, having been duly quali- fied according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will ; that I signed it will- ingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by R,1,$ARD E. C VER, the testat or this _ ��— day of 19 79 . N tart' Public Thelma S. 1 :Ca1asE�,, rG+� a:y My Commission Expires Juiy 1, 1980 Camp Nil, PA ;, Cumberland County COMMONWEALTH OF PENNSYLVANIA) SS . COUNTY OF CUMBERLAND) WE, the undersigned, 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 testator sign and execute the instrument as his Last Will; that RICHARD E. COVER signed willingly and that RICHARD E. COVER executed it ashis free and voluntary act for the purposes therein expressed; that each of us , in the hearing and sight of the testator signed the will as witnesses ; and that to the best of our knowledge the testator was at that time 18 or more years of age , of sound mind and under no constraint or undue influence. r Sworn to and_-5e subscribed before me 19 79 ' y G1�' this day of , r ARNOLD, SLIKE &BAYLEY NotAry Public ATTORNEYS AT LAW 2109 MARKET STREET �ubllc CAMP HILL,PENNSYLVANIA 11011 Thelma S. McCauslin, NOtary My Commission Expires July 1,1930 Camp Hill, PA Cumberland County