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HomeMy WebLinkAbout04-24-13 PETITION FOR GRANT OF LETTERS REGISTER OF WILLS OF l 7UO/ t J COUNTY,PENNSYLVANIA Petitioner(s) named below, who is/are i$ 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 tr{fah, Name: "T`k4./= � 55'�JPL File No: V _11i' a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No:�07- Date of Death: 2-- Age at death: qS` Decedent was domiciled at death in County, (state)with his/her last principal residence at1 � t v -- , ht,,i=Sby Street address,Post Office and Zip Code CH ,Township or Borough County A Decedent died at �l t (-A Alp St-reet 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 Pennsylvania. ..... Personal property in Pennsylvania $ If net domiciled in Pennsylvania. ...... ....... ... Personal property in County $ Value of real estate in Pennsylvania......................................................... $� TOTAL ESTIMATED VALUE. ... $ Real estate in Pennsylvania situated at: (Attach additional sheets,ifnecessary.) Street address,Post Office and Zip Code City,Township or Borough County Ef 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 I/y p 1?q-2 and Codicil(s) thereto dated State relevant circumstances(e.g.renunciation,death of exeauor,etc.) Except as follows:after the execution ofthe 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(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. 21<0 EXCEPTIONS ❑EXCEPTIONS Petition for Grant of Letters of Administration (If applicable) c.t.a.,d.b.n.,d.b.n.c.t.a.,pendente Cite,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. � c Except as follows: Decedent was not a party to a pending divorce proceeding wherein the grounds for divorce had.%Wtablishe¢W defied-:0 in 23 Pa.C.S.§3323(g)and was neither the victim of a killing nor ever adjudicated an incapacitated person. m ❑NO EXCEPTIONS ❑EXCEPTIONS c7 :3 t-- Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the following spivisW91ty)andlArs(6Mcl additional sheets,if necessary): c -­5 t Name Relationship Address,-, Form RW-02 rev.10/1112011 Page 1 of 2 Oath of Personal Representative Official Use Only COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF Petitioner(s)Printed Name Petitioner(s)Printed Address v4e 005 0 -SP— The Petitioner(s)above-named swear(s)or affirim(s)the statements in the foregoing Petition are tnie and correct to the best of the knowledge and belief of Petitioner(s)and that,as Personal Representative(s)of thn Decedent,the Petitioner(s)will well and truly administer the estate according to law. Sworn to ffirmed a d subs ibed b f Date ql�y))3 Date t ay of fin Date y: W In I I, U I v I o the Register 99��w Date BOND Required: 0 YE� NO To the Register of Wills: FEES: Please enter my appearance by my signature below: Letters. . . . .. . . . 2,0,00 Attorney Signature: Short Certificate(s).. .. . . C 0 Renunciation(s).. . . . . . . . Codicil(s), . . . . . . . . . . . . Affidavit(s).. . . .. . . . . . . V. Bond.. ... . .. .. .. . ..... .. Printed Name: Commission. . .. .. . . . . ...... . . Supreme Court G C> Other. .. . ... ID Number: rn IV-). Firm Name: jc; Address: Tr e- . . . .. . . Phone: Automation Fee. . . . . . . . . . . .. . . _{57,_CD Fax: JCS Fee. . . ... .. . . . . .. . . .. a2.50 Email: TOTAL. . . .. . . . S JA 0 DECREE OF THE REGISTER nrk, HOV ' j3r -123 Cq& Estate of W-1 File No: a/lda: AND NOW, ,�q in conside ation of the f, regoing Petition, satisfactory proof having been preserked before me,IT IS DECREED 1hat Letters v are hereby granted to V 4r 1A4 in the above estate and(if applicable)that the instrument(s)dated Man 14. 149S described in the Petition be admitted to probate and filed of record as the last Will(and Codicil(s))of Decedent thaa-' An Lh . Rwbo'"k Register of Wills Page 0 1 ff 2 Farm RW-02 rev. 1011112011 M05.905 UV.(8/11) This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph, RECORDED OF-FiME OF f lip Yf t S i 1E.t' OF 'YV i'.. � ,(I lJtllnsllsiiiiii �W`✓WV+,{. `�•� -Vv_UN••rvws+.� /)I '�ZH OFp 1013 APR tI # t"" - ✓,a-= Marina O'ReilIy Matthew I dye . _- a State Registrar CLERK OF DEC 1 7 2012 70859$ 8RPHANS' COC ",Mai°9gr ENTO��``P~(tr No. , Dare Type/Print In COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH+'VITAL RECORDS Permana k nt .CERTIFICATE OF DEATH - Black In State File Number: 1.Decedent's Legal Nam¢(First,Middle,Last,Suffix) 2,Sex 3.Social Security Number 4.Date of Death(MO/Day/yr)(Spell Mo) Jack G. Hovis, Sr. Male 207-16-3844 October 25, 2012 51.Age-Last Birthday(Yrs) 5b.Under 1 Year 5c.Under 1 Da 6.Date of Birth(Mo/Day/Year)(Spool Month) 7a.Birthplace(City and State or Foreign Country) Months Days Hours Minutes Turtle Creel< PA 85 December 10,.-1926 7tr.Birthplace(County} Allegheny 8a.Residence(State-Foreign Country} 8b.Residence(Street and Number-include Apt No.} Sc.Did Decedent Live in a Township? Penns Ivan is ®yes,decedent lived In_Silver Spring two. ad.Residence(caunry) 1213 nce ener" Drive: Cumberland 8e.Reside (Zip Code) 170$0 JE31,10,decedent lived within limits of city/boro. 9.Ever in US Armed Forces? 10-Mental Status a[Time of Death Married [3 Widowed 11,Surviving Spouse's Name(If-ifs,give Ham¢prior to fl-marriage) ®Yes [3 No 0 Unknown E3 Divorced Q Never Marri.d O Unknown Loraine V- Ze l lmev 12.Father's Name(First,Middle,Last,Suffix) 13,Mother's Nama Prior to First Marriage(First,Middle,Last) An , A lour Elizabeth Noll 14a.Informant's Name W Relationship to Decedent 14c.informant's Mailing Address(Street and Nvmbe r,City,State,MP Codej .Mrs. Laraine V. H-1--s Wi£e 1213 Scener Drive, Mechanicsburg, PA 17050 .... ......................................... .... ..-................................. . P ace o on one _ ........... mss. ...... .........................oat. .,,...........):........... `s if Death(Jccurred in a Hospital: 101 In Patient •• ...spit,.,,...•••••-.•- ••••,••••••••.••••••••............•• •••••••-•••••••••••-.•••• `If Death Occurred Somewhere 0<her Thin a Hospital: �(HOSpIre Faclll#y �Decedant's Home Emergency Roam/Outpatient [] Dead on Arrival Nursing Nome/Lon -Term Care Facility Other(Specify) 15b.Facility Name(If not institution,glva.,.-and number; 15c.City or Town,State,and Zlp Cod¢ 15d,County of Death H S irit 1os ital Cam 1311 PA 17011 Cumberland m 16a.Mat od of Disposition C7'BgHai Cremation 16b:Da'a df Disposition 16C.Place of Dlsp-Rion(Narpg pf cemetery,crematory,or other place) E3 Removal from State Donation } O[har(Spocl4) Oct. 9, 2012 C-mammon Society of PA 16d.Location of Disposition(City or Town,State,and Zip) 17a.5 n e of-nersl Service Uca a or Person in Charge of Interment 17b.License Number Aarrisbur PA 17109 FD-138753 17c.Name and Complete Address of Funeral Facility Auer Cremation Services o£ Penns lvan:L Inc. 41.00 Jonesto Road Harrisbur PA 17109 18.Decedent's Education-Check the box that best describes the 19.Decedent of Hispanic Origin-Check the 2-,D ecedent's Race-Check ONE OR MORE-.as to Indicate what Highest degree or level Of school completed at the time of death. box that bast describes whether the decedent the decadent considered himself or herseif to be, Q gth grade or toss is Spanish/Hispanic/Latino. Check the"No*' IM White Q Korean E3 No diploma,9th-12th grade box if decadent is not SPanlsh/Hispanic/Latino. C-]Black or African American p Vietnamese [] High school S-d" or GED completed No,not Spanish/Hispanic/Latino C3 American Indian or Alaska Native [=Other Asian 23 Some college credit,but no degra¢ []Yes,Mexican,Mexican American,Chicano C]Asian Indian C3 Native Hawaiian [3 Associate degree(e.g.AA,AS) C�Yes,Puerto Rican Ca Chinese L3 Guamanian or Chamorro © Bachelors degree(e.8.BA,AB,BS) Q Yes,Cuban C7 Filipino (- Samoan EZ,[�Master's degree(e.g.MA.MS,MEng,MEd,MSW,MBA) Cj Yes,other Spanish/Hispanic/Latino E3 Japanese Q Other Pacific Islander Doctorate(e.g,PhD,EdD)or Professional degree (Specify) C3 Other(Specify) .MD ODS DVM LLB JD 21.0 acada,--s Single Raca Seif-Designation-Check ONLY ONE to indicate what the decade-considered himself or herseN to be. 22a.D¢Cadent's Usual Occupation-indicate type of work 10 White [3 Japanese E3 Samoan done during most of working life. DO NOT USE RETIRED. C3 Black or African American E3 Korean p Other Pacific Islander 1_-3A merican Indian or Alaska Native r3 Vietnamese r] Don't Know/Not Sure Case W-kev SupevVisor tm E3 Asian Indian C3 Other Asian []Refused 22b.Kind Of Business/Industry [3 Chinese []Native Hawaiian )]Other(Specify) .E3 FiaPina E3 Guamanian or Chamarro Commonwealth of PA ITEMS 23a-23d MUST BE COMPLETED 23a.Date Pronounc d Dea Mo Day r b.Signature of Person Pronouncing Deelh(Only when applicable 23c.License Number By CERTIFIES DEATH(PRONOUNCES OR Rn/�.�30. 13 23d.Date 51gn (Mo/D r) 24.Time f Death Was Medical Examiner or Coroner Contacted? Q Yes No CAUSE OF DEATH Approx(ma<e 26.Part 1. Enter the chain of evantg--diseases,injuries,or compit tiona--that directly caused the death. DO NOTenter terminal events such as cardiac arrest, Interval: respiratory arrest,or Ventricular fibrillation without showir%fthp etiology. DO NOT ABBREVIATE. Enter only one cause on a line.Add additional Imes if necessary Onset to Death IMMEDIATE CAUSE ----------> a a{(/i(,/L.T Y4�n i a - (Final disease Or condition Due to(or as a q f): g resulting in death) Ip b. Sequentially list conditions, Due to(or as a consequence of): " If any,leading to the cause listed on line a, Enter the ; UNDERLYING CAUSE Due to(or-a con - (dlsease or injury that sequence of): ,.. inittated the events resulting d. 3 �e to death}LAST. Due to(or as a consequence of): �} 26.Port it. Enter other significant conditio ontributintt,ta death but not resulting in the underlying cause given in Part l 27.Was an autopsy erf adz 28.Were autopsy firs ngs available to c pieta tM1a cause of death? 29.if Female: 30. dJ�bacco Use Contribute to Dea[hT i. f Death oQ Yes No r E3 Not pregnant within past year uf' Ves [] Probably g',{JS�Ni�Natural C] Homicide S E3 Pregnant at time of death [] Unknown ''Q-ACCiden< [] Pending Investigation (] Not pregnant,but pregnant within 42 days of death []Sviclde- C3 Could not be determined f E3 Not pregnant,but pregnant 43 days to 1 year before death 32.Data of Injury(MO/DayjYr)(Spell Month) Csc J -)3 Unknown#f prognantwithin the past yaar ... 33-Time of injury 34.Place of Injury(e.g.home;construction site;farm;school) 3S.Location of Injury Street and Number,City,State,Zip Code) 36.Injury at Work FE3 f Transportation injury,Specify: 38.Describe Haw Injury Occurred: [7 Yes nvar/Opemtor [j Pedestrian 0 No asseng er C] Other(Specify) 39a.Certifier(check only ono): )M Certifying physician-'To the best Of my knowledge,death Occurred due to the--(s)and manner stated tz-) [3 Pronouncing&Certifyi physl - e best of my knowledge,death oceu-d at the time,date,and place,and due to the--(s)and manners<ated ,...k^� E3 Medlcat Examiner/Coro er-0 bs f examination,and o n estigation,in my opinion,des at the Lime,date,and place,and du t e(s a 5lgnature of certlfler: ntle of certifier: Ca Ucense N. 39b. m r ysa�d�f e le in�Cgus t ea (Rem 2 t r� IJ�"' --! 39c Da� jv7 a r} 40.Registrar's District Number 41.Registrar's 5lgnature -•wfJi 112,Roglstr r F a(DaDt (MO Dayr r 43.Amandmanis °�°?- a �� r• d4... G! An H1oS-143 DisPOSition Permit No. 0830442 _ RFV nT lint t LAST WILL AND TESTAMENT OF JACK G. HOVIS, SR. I, Jack G. Hovis, Sr. , of silver spring Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke all Wills and codicils previously made by me. ITEM I: I direct that all my legally enforceable debts and funeral expenses, including all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II: I bequeath my tools, my stamp collection and my jewelry to my son, Jack G. Hovis, Jr. , of Mt. Laurel, New Jersey. ITEM III: I bequeath any automobiles or motor vehicles I may own at my death, my personal effects, such household goods if any as may be my individual property and not the property of my wife or owned jointly by me with her, and other tangible personal property of like nature (not including cash or securities) , together with any existing insurance thereon, to my wife, Loraine Hovis, providing she survives me by thirty (30) days. Should my said wife predecease me or die on or before the thirtieth day following my death, I bequeath such tangible personal property and insurance thereon to such of my children as are living on the thirty-first day after my death, to be divided among them by my personal representative(s) with due regard for their personal preferences in as nearly equal shares as practical. I direct that any of the foregoing articles not selected by my said children shall be sold at public or private sale by my personal representative(s) , and I further direct that the net proceeds tthereb-T shall .,be administered and distributed as a part of the fp�' i c u 4� r 1)io of 'p'-y"--estate. C= 7 UJ V) ca= co U'l ITEM IV: I devise and bequeath the residue of my estate of every nature and wherever situate to my said wife, providing she survives me by thirty (30) days. ITEM V: Should my said wife predecease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate of every nature and wherever situate in equal shares to my children, provided that the share of any child who predeceases me or dies on or before the thirtieth day following my death shall be distributed to his or her issue, per stirpes, living on the thirty-first day following my death, and in default of any such then living issue, such share shall be added to the share or shares for my other children. ITEM VI: Should any person entitled to a share of my estate not have attained the age of twenty-one (21) years at the time of distribution to him or her, I devise and bequeath the share of each such person to my Trustee hereinafter named, IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so received, and the accumulation of income thereon, and to use and apply the income and principal, or so much thereof as, in the sole discretion of my Trustee, may be necessary or appropriate for such beneficiary's support, health and medical care, and education (including college education, both undergraduate and graduate) , or to make payment for these purposes, without further obligation or responsibility to see to the proper expenditure thereof, directly to such beneficiary or to any person taking care of such beneficiary. Any principal or income not so applied shall be distributed to such beneficiary absolutely when he or she attains the age of twenty-one (21) years. If he or she dies before attaining age twenty-one (21) , such share shall be distributed to his or her personal representative(s) , discharged of the trust. V'_� , Y ITEM VII: No beneficial interest under any of the trusts held hereunder, whether in income or principal, shall be subject to anticipation, assignment, pledge, sale or transfer in any manner, nor shall any beneficiary have the power to anticipate, encumber or charge such interest, nor shall such interest, while in the possession of the Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary. ITEM VIII: All Federal, State and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether passing under this Will or otherwise, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my residuary estate without apportionment or right of reimbursement. ITEM IX: I appoint Dauphin Deposit Bank and Trust Company, Harrisburg, Pennsylvania, Trustee of any trust established under this my last will. ITEM X: I appoint my said wife Executrix of this my last Will. Should my said wife fail to qualify or cease to act as vExecutrix, I appoint my children, Jack G. Hovis, Jr. of Mt. Laurel, New Jersey, Joyce V. Myers, of Mechanicsburg, Pennsylvania, and Janice L. Hovis, of New Castle, Pennsylvania, co-Executors of this my last Will. ITEM XI: I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this day of a'Y r 1993. ,,466_[SEAL] The preceding instrument, consisting of three typewritten pages, each identified by the signature of the Testator, was on the date thereof, signed, published and declared by Jack G. Hovis, Sr. , the Testator therein named, as and for his last Will, in the presence of us, who, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. r COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND We, Jack G. Hovis, Sr. , Michael R. Rundle and Mary M. Price, the Testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last Will and that he has signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. r es a or Witness / Witness Subscribed, sworn to and acknowledged before me by Jack G. Hovis, Sr. , the Testator, and subscribed and sworn to before me by Michael R. Rundle and Mary M. Price, witnesses, this day of �`l{ , 1993. C ? _ ; Notary PubjAc C7 RENUNCIATION +M+Yid � -) y REGISTER OF WILLS --- L?Lfr �Pi'� C� COUNTY, PENNSYLVAl y r— Ul Estate of k ` �1 /� v ,Deceased in my capacity/relationship as (Print Name) _ Aiko of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to (Bate) ( gnature) v b g 421 (Street Address) City,State.Zip) Executed in Register's Office Executed out of Register's Office Sworn to or affirmo and subscribed Before the undersigned personally appeared the before me this 'S day party executing this renunciation and certified of that he or she executed the renunciation for the purposes stated within on this day of , IeLpputyy far egister of Wills Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Farm RW-06 rev.10.13.06 M C> M C-> rn c-.) u C� r— rQ '17 t­l m Cz, )> C) D ENUNCIATIUN- 21 �1�2R OF WILLS Ul 0 NT U Y, PENNSYLVANIA Estate of -, Deceased 1, in my capacity/relationship as --- (P11 t Name) of the above Decedent,hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to 1741, (Date) (Signature) (Street Addr ------ (City,State.Zip) Executed in Register's Office Executed out of Register's Office Sworn to or aff ' d and subscribed Before the undersigned personally appeared the before e this I _.day party executing this renunciation and certified )f J_ that he or she executed the renunciation for the purposes stated within on this day d-ttz— of `f t for Register of Wills Notary Public y My Commission Expires: (Signature and Sea]of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) '-06 rev. 10.13.06