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Home My WebLink About06-17-13 PETITION FOR GRANT OF LETTERS REGISTER OF WILLS C�F 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: Decedent's Information Name: Helen I.Kelly File No: 21 -13 °" �� a/k/a: (Assigned by Register) a/k/a: a/k/a: Social Security No: 088-12-6312 Date of Death: 05/03/2013 Age at Death: 91 Decedent was domiciled at death in Cumberland County, pA (State)with his/her last principal residence at Forest Park Nursing Home Carlisle Cumberland Street address,Post Office and Zip Code City,Township or Borough County Decedent died at Forest Park Nursing Home,700 Walnut Bottom Road Carlisle 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 $ 400,000.00 If not domiciled in Pennsylvania................. Personal property in Pennsylvania $ If not domiciled in Pennsylvania................. Personal property in County $ Va/ue of real estate in Pennsylvania........... $ TOTAL ESTIMATED VALUE$ 400,000.00 Real estate in Pennsylvania situated at None (Attach additional sheets,rf necessary.) Street address,Post Office and Zip Code City,Township or Borough County ❑X A. Petition for Probate and Grant of Letters Testamentarv Petitioner(s)aver(s)that he/she/they is/are the Executor(s)named in the Last Witl of the Decedent,dated 02/21/1989 and Codicil(s) thereto dated (State re%vant circumstances,e.g.,renunciation,death of executor,etc.) Except as follows:after the execution of the instrument(s)offered for probate,Decedent did not mar ,was not divorced,was not a party to a pending divorce proceeding wherein the grounds for divorce had been estabtished as defined in 23 Pa.C.S.�3323(g),and did not have a child born or adopte�;and Decedent was neither the victim of a killing nor ever adjudicated an incapacitated person. �X NO EXCEPTIONS�EXCEPTIONS ❑6. Petition for Grant of Letters of Administration (If applicable) c..a.; . .n.; . .n.c..a.;pe en e �e; uran e a sen ia; uran e m►non a e 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 v�ctim of a killing nor ever adudicated an incapacitated person. �X NO EXCEPTIONS�EXCEPTIONS � ��'`�,,' Petitioner(s),after a proper search has/have ascertained that Decedent left no Will and was survived by the following spou if,�,y)and hei�attach�? �, ? additiona/sheets,if necessary): � �j � �"R n � � C7 � � ,� Name Relationship Address � rr� � � � , � � o � h �j "L� '� '.�7 C:� � � � � � : � � �... � 't"j '� ,�-�.- i�"7 �" {\? C!j 4 0 � Form RW-OZ�v.10-11-2011 Copyright(c)2011 form software only The lackner Group,tnc. Page 1 of 2 Oath of Personal Representative Officiai Use Only COMMONWEALTH OF PENNSYLVANIA } } SS: COUNTY OF Cumberland } Petitioner(s)Printed Name Petitioner(s)Printed Address Deidre K.Gannon 858 Acri Road � Mechanicsburg,PA 17050 � � � � � n O� � � � � �' �r° a" rn �—' � m �,. � � -.3 :� � z . � o � � � ° � "� -►� �� ; � oo �-- r z The Petitioner(s)above-named swear(s)or affirm(s)the statements in the foregoing.Petition are true and correct the best of tt�,([nowt�rdg�And belief of Petitioner(s)and that,as Personal Representative(s)of the Decedent,Petitioner(s)will well and truly ad tnister the esti�##waccording b law. Sworn to r ffrmed and subscribed before ��.�-..�='�-�' :%�� °� Date /7 �� me t ' �day of �� Date By; Date F t e Register • Date BOND Required? � Yes � No To the Register of Wills: FEES Please enter my appearance by my signature below: Letters............................................ $ 360A0 Attorney Signatur : t 5 )Short Certificate(s).......... 25.00 .- � c ��enunciation(s)............... ( )Codicil(s)......................... ( )Affidavit(s)....................... Printed Name: Richard E Connell Esq Bond.............................................. Supreme Court 2�542 Commission................................... ID Number: Other Will 15.00 Inheritance Tax Return 15.00 Firm Name: Ball,Murren 8 Connell Inventory 15.00 Address: 2303 Market Street Camp Hill,PA 17011 Phone: 717/232-8731 Automation Fee............................. 5.00 Fax: 717/232-2142 JCSFee......................................... 23.50 TOTAL........................................... $ 458.50 E-mail: connell a�bmc-law.net DECREE OF THE REGISTER Date of Death: 05/03/2013 Social Security No: 088-12-6312 Estate of Helen I.Kelly File No: 21 -13�-- ��- a/k/a: ANQ NOW, , ,in consideration of the foregoing Petition, satisfactory proof ha g been presented before me,IT IS DECREED that Letters Testamentary are hereby granted to Deidre K.Gannon in the above estate and(if applicable)that the instrument(s)dated 02/21/1989 described in the Petition be admitted to probate and filed of record as th Will(a d Codi I(s))of Decedent. Register of Wills Form RW-OZ rev.10.11-2011 Copyright(c)2011 form software only The Lackner Group,Inc. o ' 1 .� ti � U : � OATH OF NON-SUBSCRIBING WITNESS(ES) � REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Helen I. Kelly , Deceased Deidre K.Gannon and Thomas P.Gannon , (Print Name/s) (Print Name/s) (each) being duly qualified according to law, depose(s) and say(s) that she/he/they was/were well- acquainted with Helen I. Kelly and am/are familiar with the handwriting and signature of the decedent, and that the signature of He�en�.Kelly to the foregoing instrument purporting to be the Last Will and Testament/Codicil of Helen I. Kelly is in his/her own proper handwriting. � l.9- �� --��«^��-� Deidre K. G �.., ignature) Thomas P. Gannon �`�..., 858 Acri Road 858 Acri Road (Street Add►ess) (Street Address) Mechanicsburg, PA 17050 Mechanicsburg, PA 17050 (City,State,Zip) (City,State,Zip) Executed in Register's Office Sworn to or affirmed and subscribed " c� � � befor me thi th day � o `"' � +�*� of � � � c_ � c� l�t,/L,�r , -z� � ._ c� „ , � � c3 z cn � j��R � A� r f„_, --� C� � �'" � � � � � D for Register of Wil ,��, • �c a � � c� _-� � -� 3 � � � � � : � � -- e� � � � � 3� N cn e� w � Form RUV 04 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. H105.805 REV(9/11) �, � LOCAL REGISTRAR'S CERTIFICATION OF DEATH � "�" WARNING: It is iliegal to duplicat� this copy by photostat or photograph. ` �EC�R��D O�F'l�E aF Fee for this certificate, $6.00 R�'��`�'�� j� ''''`jK�OF p�"'"�--_; This is to certify that the information here given is ,,,�� P- Eiy�,f`_ correctly copied from an original Certi�cate of Death -,,�� U�f �� __ _ duly filed with me as Local Registrar. The original tV � � ,� -= �9; certificate will be forwarded to the State Vital �° �' � a; Records Office for permanent filing. cL��K aF =oF -_ _-- ��,. P 19628437 . -�9 - .�,�.�,,��'�� MAY � 2 �3 a R P M A N S C 0 U� '�--9liyENT�0�;,;��'''� Certification Number G U!�B ERl.A N D C 0,, �'�_ __ Local Registrar Date Issued _ _ _ _ . __ ___ _ _ __._ _ �Type/Print In COMMONWEALTH OF PENNSYIVANtA�DEPARTMENT OF HEALTH•VITAI RECORDS P��^""�"` CERTIFICATE OF �EATH ��, ^ Black Ink State Fil�Number: •` 1.Decedent's Legal Name(First,Middle,Last,Suffix) 2.Sex 3.Soclal Securicy Number 4.Date of Death(MO/Day/Yr)(Spell Mo) . Helen Kell female 088-12-6312 Ma 3 2013 - Sa.Age-Last Blrthday(Yrs) Sb.Under 1 Year Sc.Undsr 1 Da 6.Date of Bir[h(MO/Day/Vear)(Spell Month) 7a.Birthplace(CI d State or For�ign Country) �Mortths Days Hours Minutes Broo�c� NY �� 91 October 15 1921 7b.Birthplace(County) � S 8a.Resid�nce(State or Foreign Country) 8b.Residence(Street and Number-Include Apt No.) Sc.Did Decedent Liva in a Township? ' pa. ��es,decedenT Iived tn FaS t Pennsboro �,,,P. 's 8d.Residence(COUnty) . HSH ri Road � � �][(l�,gr3,$j1d 8e.Residence(21p Gode) 1 Q,'rjQ 0 No,decedent Ilved within Ilmits of � city/boro. a 9.Ever in US med Forces7 10.Marital Status at Time of Death O Married [�Widowed 11_Surviving Spouse's Name(If wife,gfve name prior to flrst marriage) �Yes �o �Unknown � Divorced � Never Married �Unknown t 12.Father's Name(First,Middle,Last,Suffix) � 13.MothePs Namc Prior to First Marriage(First,Middle,last) ± James McDonnell Mar Wha len � 14a.Informant's Name S4b.Relationship to Decedent 14c.Informant's Mailing Address(Street and Number,City,State,Ztp Code) � ' o Deidr G on Da hter 858 Acri. Road Mechanicsbur Pa 17050 G _ r� �� - -- - --- - -- -1 a_PT c_o Deat ec on�one _ - - -- __ �__ - - _ c If Death Occurred in a Hospital: d inpatient 11f Death Occurred Somewhere..Other Than a Hospital d Hospice Facflity t7 De[edent's Home ° � Emergeney Room/O�tpatient � � Dead on Arrival � ]`d[Nursing Home/long-Term Care Facillty Q Other(Specify) � � 15b.Facility Name(If not InstiWtion,give stre�!and number) 15c.City or Tow�,State,and 2ip Code i5d.Cou�ty o Death� � � ? � Forest Parlc Nursi Home Carlisle Pa G�unberland � � 16a.Method of DlspoSiHon �Burial � Grematton 16b.Date of Disposition 16c.Place of Dispositlon(Name of ceme�ery,crema�ory,or other plac�) � � [] Removal from Siate p Donation � O�-Other(Specify 13- St JoYin Neumann Cemeter � lBd.Loeatian oi D1spositlon(City orTown,State,and Zip) a.5lgnature Funeral e or P rson in Cfiarge of�lnterme�t 17b.License N.umber ' � lfont Pa. 011654-L ` 17c.Name and Comptete Address of Funeral Facility � � � M ers-Harner �neral Home Inc 1903 Market Street Hill Pa 17011 g e� 18.DecedenYs Educatlon-Check the box that best describes the 19.Decedent of Mlspanic Origin-Check the 20.Decedent's Race-Check ONE OR MORE races to indica�e what � ►°- highest degrew or level of school completed at the time of death. box that b�st describes whether tha dacadent e decedcnt considered himself or herself to be_ � � 8th grade or less is Spanish/Hispanic/Lattno. Check the"NO" White O Korean � � No diploma,9th-12th grode b x if dec�dent fs not Spanish/Hfspanic/Lattno_ � Black or AfNcan American � Vi�tnamese High school graduate or GED completed �o,not Spanish/Hispanic/Latlno O American I�dian or Alaska Natfve � Other Asian � p Some college credit,but no degree �Ves,Mexican,Mexican American,Chiwno p Asian Indian � Native Hawailan � � O Associate degree(e.g.AA,AS) �Yes,Puerto Rican O Chinese O Guamanian or Chamorro 3 0 Bachelor's degree(e.g.BA,AB,BS) 0 Ves,Cuban � Filtpino 0 Samoan � � Master's degree(e.g.MA,M5,MEng,MEd,MSW,MBA) �Ves,other Spanish/Hispanic/Latino p Japanese 0 Other Paciflc istander � � Doctorote(e.g.PhD,EdD)or Professional degree (Specify) �Other(Specify) e. .MD DDS DVM LLB JD . 21,t�ecedent's Single Race Self-Desig�ailon-Check ONLY ONE to indicate what the decedent considered himself or herself to be. 22a.Decedent's Usual Occupation-Indtcate type of work �]White �Japanese � Samoan done during most of working Iife. DO NOT USE RETIRED. 0 Black or AfHcan American � Korean � Other Paciflc Islander � �Am�Ncan Indlan or Alaska Nativ� �Victnamese � Don't Know/Not Sure .SeGret'dr' _ �Astan Indlan �Other Asian � Refus�d 22b.Kind of Busin�ss/Industry a� O Chinese O Nativ�Hawatian O Other(Specify) �� Filipino 0 Guamanian or Chamorro a JoY�n Blair Adverti.si REMS 23a+�23d MUST BE COMPLETED 23a.Oate Prono nced Dead(Mo Day r) �23tr.Signature of Person Pronouncing Death(Oniy when appHcable 23G.Uc�nse N�mher � BV PERSON WNO PRONOUNCES OR � O5/O'� a o�3 �.N . � FLr��c�y 5a�a CERTtF1E .�PATM � � 23d.U91te��tgned Mo/�ay/Vr)� 24.Time of Death � �� 25.Was Medical Examiner or Coroner ContactedT � Yes. No CAUSE OF DEATH � qpproximate 26.P�R 1. Enter the ehatn of ev�nts--diseas�s,injurles,or complications--that directly caused the daath. DO NOT enter termfnbl events S�cli as cardiac arrest, � Ir+terval: resplra[ory arrest,or ventr�wlar flbrillatio�without showing the etiology. DO NOT ABBREVIATE. Enter o�ly one cause on a Iine. Add additional Itnes if�ecessary. 1 Onset to Death IMMEDIATE CAUSE ------------> a. ,/Y�yO C J��D�i�L- �/✓�AiG G 7-� 0� � � (Final disease or conditlon Due to(or as a consequence of): � resulting in death) --y-�� . I� ! , �aQ�� - � b. G:G1V�IA/) �?s�`(� � T 1 � Sequentially Itst conditions, Due to(or as a conseq�ence o�: . � If any,teading�to the cause 1 . Ilsted o�Iine a. Enter[he c. � � � UNDERLYING GAUSE Due to(or as a consequence ofl:� � � (dlsesse or in}ury that � � � F Initiated the evenu resulting d. � � ln desth)WST. Due to(or as a eonsequ�nc�of): . � . � � � 26�.Pa�rt N.£nter other sianifiwnt conditions contributin¢to death but�ot rtsulting in the underlying cause given in Part 1_ � 27.Was an au[opsy pe�rfo��d? � � V-�P/�� - y � C� Yas B�No �� 2$.Were autopsy fi�dings avallable �. to compiete the caus of d�ath7 0 Yes o � � 29.If Fe . 30.Did Tobacco Use Contribute to DeathT 31.M er of Death � � Not pregnant within past year O Ves � Probably Natural � Homicide S � Pregnant at time of death p No ��Crnknown 0 Accident � Pe�ding Investigation � a�' � Not prcgnant,but pregnant within 42 days of daath . � Sulcida p Could not be determtned T� �°- O Not pregnant,but pregnant 43 days to 1 year before death 32.Date of In)ury(Mo/Day/Yr)(Spell Month) . p Unknown if pregnant wiYhin the past year. 33.Time of Inj�ry �� 34.Place of InJury(e.g.home;construction site;farm;school) 35.Location of InJury(Sfreet and Number,City,County,State,Zip Code) 3 � 36.InJury at Work 37.If Transportation InJury,Specify: 38.DescAbe How Injury Occurred: . � � Yes � Driver/Operetor � Pedestrlan �No p Passe�ger O Other(5pecify) � 39a. rtifier-physlcian,certified nurse practitfo�er,medical examiner/coroner(Gheck only one): CeKifying oniy-To the best of my knowiedge,death occurred due to he w�se(s)and manner stated. � O Pronouncing 8�CerNfytng-To the best of my knowledge,death occu r at the time,date,and place,and due to the cause(s)and manner stated. 0 Medieal Examiner/Coroner-On the basis mination and/or inve t atfon,in my opinfon,death oceurred at the time,date,and place,and due to the cause(s)and mannGer�stated. S�gnatura of certifler; Title of certifier. �� license Number:�r�If��'S / � o.� 39b.Name,Addr�ss and Lp de of Pe�on Completing Cause of Death(Item 26) � . 39c,DaLe Si�rled Mo/D �/Yr� J xs' � c� r � �o s. i,� � � � � � � 40.ReQistrar s Istrict.-umber � . 41.Registrar's Sig re � 42.Regfstrar Ff e ate�� Mo Day�� r� 02/-o� /� � .'S� /7 �7°/r3 ,� 43.Amandments . � � 3 3 _ � �S �/ `� � H305-143 DlsoosiUon Permit No. ✓ RFV n7/�l11� f � �'i �'i { !^y i.I \! � 1 4, r. Q C`� (� C�'3 !��: � � � �� J � rn � � z �na �; � Dr- � ...t � � � � � '.r � !� � �� :: � ;+, %. C :�� C� � C � �� „t1 ; !� LAST WILL AND TESTAMENT �'' ° �� 3 - a' -a --� �' r' m 'i �F � rv tn G i �� i; HELEN I. KELLY �� i- '; ; ;; ; `i I� i I� I, HELEN I. KELLY, presently domiciled at 10 ; �i Hummingbird Lane, Whiting, in the Township of Manchester, � . j� ; ;� County of Ocean and State of New Jersey, do hereby make, ; , j� j �� publish and declare this instrument to be my Last Will and ! � ;j Testament, revoking all former Wills and Codicils: ; il � „ '� FIRST: I direct that my just debts and funeral ; ;; expenses be paid as soon after my death as may be done ! i i� conveniently. ; �; � i� SECOND: I give, devise and bequeath all the 4} �i rest; residue and remainder of my estate, be the same real, j �i ; i' personal or mixed and wheresoever situate, to my husband, �I i � '� FRANK X. KELLY. Should he predecease me, or fail to survive , ;I ;� i i! me for a period of thirty (30) days after my death, then the ; ;! rest, residue and remainder of my estate shall be ij � �4 distributed to my daughter, DEIDRE GANNON. Should she also i ,� ; ij i ; have predeceased me, or fail to survive me for a period of ;; i �� thirty (30) days after my death, then the rest, residue or ; ,{ I I i I; remainder of my estate shall be distributed, in equal � �I ; �; shares, to my grandchildren, SARA HYLAND GANNON and THOMAS � ! �i �' FRANCIS GANNON, or the survivor of them. ' `_ ;; i �� THIkD: I no�ninate and appoint m�� '.:�asband, ; �� i ' ;� FRANK X. KELLY as sole EXECUTOR of this, my Last Will and � ;. i� Testament. Should he predecease me, or having qualified die, ; '! or become incapable of completing the administration of my ,, �� i estate, then I nominate and appoint DEIDRE GANNON as � R; �� ; ;; successor EXECUTRIX. Should she also predecease me, or � . �; �, having qualified die or become incapable of completing the ; � �i � �i administration of my estate, then I nominate and appoint my � i} � � �� PAGE ONE OF THREE ; i[ ;� � i' I ;; �� ki i ji i r� 4 �; � ,, � �� ; �� . �s �; �f � 1= -i �� i� I� � � �k 'j � j; son-in-law, THOMAS P. GANNON, as successor EXECUTOR. I ; r �; ; �; � �� direct that neither my EXECUTOR, nor his successor, shall be � 1'; ' !i required to furnish any bond or other surety for the ; :� i ' faithful performancs of his or her duties in any i `f ; ':,� jurisdiction whatsoever. ' ; ;� ; ;i FOURTH: My fiduciary is directed to pay from i I� ' i! the residue of my estate, all Transfer Inheritance Taxes, ! I ' � i� Federal Estate Taxes, or other death duties that may be � �� # I+ imposed upon my estate by any jurisdiction, including such � �, I �l ! ;j taxes as may be imposed upon property passing outside the ; � ;j terms of this Will. ; �� E i! FIFTH: I expressly authorize and empower my � I` �, EXECUTOR, or his successor, to sell, mortgage, lease, or j �; , ii develop any and all real estate of which I die seized or ! 'I. ; '� ' a , ..i„ yr . ` � i� �30SS2SSE.. (�n.._..d'..g an� �n3ominium and/or cooperative of ; ; . { j! which I die seized or possessed) , at such price, at such � �� ; time and upon such terms as my EXECUTOR, or his successor, � Gj � � �+ determines to be appropriate. i I, i' i If I, HELEN I. KELLY, the Testatrix, sign my name to j " � Ii this instrument this 2l� day of February, 1989, and ! �y � ij being first duly sworn, do hereby declare to the undersigned 4 I ii authority that I sign and execute this instrument as my Last ; +I i ' } i� Will and Testament, and that I sign it willingly; that I i� � '! execute it as my free and voluntary act for the purposes ; i� r ^ `, therein expressed and that I am eighteen (18) years of age ' I� � � or older, of sound mind and under no constraint or un3u�: �� i �i influence. � : �{ ; j� -, ,; �I � ,, L.S. ;; I .� �� HELEN I. KELLY ; � < < ; r � �i . ;: ii i ,; � �` ! � �t � PAGE TWO OF THREE � � , 1 i ! �i • !I �� is ; I! � � te • �� I If i3 �, �, 1' i� �� „ i; � i I ;� WE, saSePN��ie- �u�t t�A�(¢tC and Wiu.tAAi C• 6Asp¢A y J�_ , ;` the witnesses, sign our names to this instrument, and being ; i� !i !' first duly sworn, do hereby declare to the undersigned a� �` � ;� authority that the Testatrix signs and executes this �, �? instrument as her Last Will, and that she signs it i j! willingly, and each of us, in the presence and hearing of i{ ; ;� the Testatrix, hereby signs this Will as witness to the ' i, � �; Testatrix's signing, at 2:40 �.m. , on the date and year ' � i� last above written, and that to the best of our knowledge, ; ;I the Testatrix is eighteen (18) years of age or older, of ' ';� � ;i sound mind and under no constraint or undue influence. � `I ; r; ji i � �f �r I' � � ; �.�u.,� �,�c a.�i residing at ! 7!• �i �� WITNESS `; � ;'` , -I�utll�Jr �; � residing at i� ; �� WITNESS { � ; � i � i �i ; ;i t �,� i i+ STATE OF NEW JERSEY ) � ,� `' i ;j , �i SS. : i � II COUNTY OF OCEAN ) ; i� � ;� I I; i , � I I { �� SUBSCRIBED, SWORN TO AND ACKNOWLEDGED before me by � �� HELEN I. KELLY, the Testatrix, ancl �ubscribed and swcr;� to � �f � � ' i ' �� before me by fa5eA4ule IL�a �AKoa and ; ; �� t�iu,IAM C. f�at .�r. , witnesses, this 2lbt day (i � j; of February, 1989. ' I: � ! �1 � . ' �+ � . t � �' : �� . ' �! ~f i E � Ii NOTARY PUBLIC ` ?� ME111�11 lQJ1Ni6pp i ;� A Noh�►P�rc of New 1e�t i �� PAGE THREE OF THREE ��'i� ' !� _ ° �� ... `